MANAGEMENT OUTCOMES AND ITS ASSOCIATED FACTORS OF ADULT STROKE PATIENTS ADMITTED TO PUBLIC HOSPITALS IN HARARI REGIONAL STATE, EASTERN ETHIOPIA.

Abstract

Stroke is the leading cause of disability worldwide and the second leading cause of death and disability-adjusted life years and is a public health problem in Ethiopia. Despite the high prevalence of stroke, data are scarcely published on factors contributing to poor outcomes of stroke in Eastern Ethiopia. Objectives: This study aimed to assess management outcomes and its associated factors of adult stroke patients admitted from January 1, 2020 to December 30, 2022 at public Hospital in Harari Regional State, Eastern Ethiopia, Harar City, from May 1 to July 30, 2023. Methodology: A hospital-based cross-sectional study was conducted from May 1 to July 30, 2023 on randomly selected 205 patients with stroke admitted to a public Hospitals in Harari Regional State from January 1, 2020, to December 30, 2022. Data about socio-demographic, clinical, and laboratory characteristics was collected by reviewing medical records of patients by 3 bachelors of science nurses and 2 General practitioners and data was tabulated, cleaned and enter into Epidata version 4.6 and exported into Statistical Package for Social Sciences version 27 for analysis. Assumption for binary logistic regression was met. Model fitness was checked with the Hosmer lemeshow test (p-value of 0.167) and descriptive statistics was used to describe data frequency, and mean of independent variables, and data normality was checked, median and interquartile range were used for description. Bivariable regression was done and p-value of less than 0.25 was used to select variables for multivariate analysis. Statistical significance was measured by p-value < 0.05 and adjusted odds ratio with a 95% confidence interval for associated factors of poor outcomes of adult stroke patients. Results: A total of 205 patients were analyzed in this study. The median age was 60 years with an interquartile range of 17 and males represent 51.7%. In this study 94(45.9%) patients had poor management outcomes [95% CI: 38.4%, 52.4%)] and of these 76(37.1%) died. Glasgow coma scale of ≤8 at presentation [AOR=4.5(1.6, 12.8)]. Documented aspiration pneumonia [AOR=6.5(2.5, 16.7)], and clinically diagnosed increased intracranial pressure [AOR=3.5(1.2,9.61) were significantly associated with poor outcomes of adult stroke patients. Conclusions: In this study, the mortality rate of stroke was high. Low Glasgow coma scale of at presentation, documented aspiration pneumonia, and clinically diagnosed increased intracranial pressure were predictors of poor outcomes of adult stroke patients. So, focusing on this factor reduction as well as improving management by targeting this factor is very important to reduce the associated mortality.