title: Early mortality and functional outcome after acute stroke in Uganda: prospective study with 30 day follow-up.
abstract: Identification of early outcomes post stroke and their predictors is important in stroke management strategies. We prospectively analysed 30-day outcomes (mortality and functional ability) after stroke and their predictors among patients admitted within 7 days post event to a national referral hospital in Uganda. This was a prospective study of acute stroke patients consecutively enrolled between February and July 2014. Social demographics, clinical, laboratory, imaging characteristics, outcomes (all through 30 days), time of death were assessed using standardised questionnaires. Multiple regression was used to analyse the independent influence of factors on outcomes. Of 127 patients, 88 (69.3 %) had ischemic stroke and 39 (30.7 %) had hemorrhagic stroke. Eight (6.3 %) died within 7 days, 34 (26.8 %) died within 30 days, with 2/3 of deaths occurring in hospital. Two were lost to follow up. Of 91 survivors, 49 (53.9 %) had satisfactory outcome, 42 (46.1 %) had poor functional outcome. At multivariate analysis, independent predictors of mortality at 30 days were unconsciousness (GCS <9), severe stroke at admission and elevated fasting blood sugar. None of the patients with functional independence (Barthel index ≥60) at admission died within 30 days. Inverse independent predictors of satisfactory outcome at 30 days were older age, history of hypertension and severe stroke at admission. Acute stroke patients in Uganda still have high rates of early mortality and poor functional outcomes. Independent predictors of mortality and poor functional outcome were severe stroke at admission, unconsciousness, high fasting blood sugar, old age and history of hypertension.
authors: Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7051, Kampala, Uganda.
authors: Jane
authors: J
authors: Nakibuuka
authors: Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA.
authors: Martha
authors: M
authors: Sajatovic
authors: Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7051, Kampala, Uganda.
authors: Joaniter
authors: J
authors: Nankabirwa
authors: Department of Medicine, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Charles
authors: C
authors: Ssendikadiwa
authors: University Hospitals Case Medical Center, Neurological Institute Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106 USA.
authors: Anthony J
authors: AJ
authors: Furlan
authors: Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7051, Kampala, Uganda.
authors: Elly
authors: E
authors: Katabira
authors: Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7051, Kampala, Uganda.
authors: James
authors: J
authors: Kayima
authors: Department of Medicine, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Nelson
authors: N
authors: Kalema
authors: Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
authors: Jayne
authors: J
authors: Byakika-Tusiime
authors: Department of Medicine, St Raphael of St Francis Nsambya Hospital, Nkozi University, P.O. Box 7146, Kampala, Uganda.
authors: Edward
authors: E
authors: Ddumba
keywords: Death; Function; Outcome; Stroke