Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana
Background. Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods. A prospec...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2018/7521351 |
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| author | Josephine Akpalu Alfred E. Yawson Foster Osei-Poku Yacoba Atiase Ernest Yorke Patrick Adjei Kodwo Nkromah Albert Akpalu |
| author_facet | Josephine Akpalu Alfred E. Yawson Foster Osei-Poku Yacoba Atiase Ernest Yorke Patrick Adjei Kodwo Nkromah Albert Akpalu |
| author_sort | Josephine Akpalu |
| collection | DOAJ |
| description | Background. Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods. A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale. Results. Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients. Conclusion. Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes. |
| format | Article |
| id | doaj-art-6de8b5d9cc1844559ae3c6bfd390b304 |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-6de8b5d9cc1844559ae3c6bfd390b3042025-02-03T01:31:17ZengWileyStroke Research and Treatment2090-81052042-00562018-01-01201810.1155/2018/75213517521351Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in GhanaJosephine Akpalu0Alfred E. Yawson1Foster Osei-Poku2Yacoba Atiase3Ernest Yorke4Patrick Adjei5Kodwo Nkromah6Albert Akpalu7Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box GP 4236, Accra, GhanaDepartment of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, GhanaDepartment of Medicine and Therapeutics, Korle Bu Teaching Hospital, P.O. Box KB 77, Korle Bu, Accra, GhanaDepartment of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box GP 4236, Accra, GhanaDepartment of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box GP 4236, Accra, GhanaDepartment of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box GP 4236, Accra, GhanaDepartment of Medicine and Therapeutics, Korle Bu Teaching Hospital, P.O. Box KB 77, Korle Bu, Accra, GhanaDepartment of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box GP 4236, Accra, GhanaBackground. Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods. A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale. Results. Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients. Conclusion. Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes.http://dx.doi.org/10.1155/2018/7521351 |
| spellingShingle | Josephine Akpalu Alfred E. Yawson Foster Osei-Poku Yacoba Atiase Ernest Yorke Patrick Adjei Kodwo Nkromah Albert Akpalu Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana Stroke Research and Treatment |
| title | Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana |
| title_full | Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana |
| title_fullStr | Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana |
| title_full_unstemmed | Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana |
| title_short | Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana |
| title_sort | stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in ghana |
| url | http://dx.doi.org/10.1155/2018/7521351 |
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