Abstract
Background: The burden of stroke is high in Africa, but few data are available on the long-term
outcome of strokes in this area. Aim: We aimed to study the long-term outcome of stroke survivors in Parakou from 2012
to 2018. Methods of Study: It was a cohort study and included 247 stroke patients admitted to the University
Hospital of Parakou from January 1, 2012 to April 30, 2018. Each patient was followed
up for at least 1 year. The modified RANKIN scale was used to evaluate patients. Verbal
autopsy was used to ascertain the cause of death. The survival probability was estimated
using the Kaplan-Meier method. Predictors of mortality were estimated using the Cox
proportional model and the hazard ratio (HR) and their 95% confidence intervals were
determined. The data were analyzed using Stata Software. Results: The mean age was 58.1 ± 13.4 years with a sex ratio of 1.12. Among stroke survivors,
the mortality was 10.1% at 3 months, 11.7% at 6 months, 15.4% at 1 year, 21.5% at
3 years, and 23.5% at 5 years. The probability of survival after a stroke was 66.5%
at 5 years. Factors associated with mortality were age with adjusted HR 1.4 (1.2-1.7)
for each 10 years, male sex with aHR 2.3 (1.2-4.6), history of hypertension with aHR
2.0 (1.0-4.1) and the severity of the initial neurological impairment National Institute
of Health Stroke Scale with aHR 1.1 (1.0-1.2) for each 1 point. The main causes of
death were recurrent stroke, infectious diseases, and cardiac disease. The proportion
of patients with functional disability was 53.8% at 1 year. The quality of life was
generally impaired in terms of physical health, personal environment, and finances.
Conclusions: The long-term prognosis of stroke patients in Parakou is poor. It requires urgent
action to reduce this burden.
Key Words
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Article info
Publication history
Published online: March 19, 2020
Accepted:
February 21,
2020
Received in revised form:
January 13,
2020
Received:
August 27,
2019
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104785
Copyright
© 2020 Elsevier Inc. All rights reserved.
