Stroke in a resource-constrained hospital in Madagascar
Abstract Background Stroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients...
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doaj-5efd949b5c31494ebffed10d5e9caa872020-11-25T01:57:03ZengBMCBMC Research Notes1756-05002017-07-011011810.1186/s13104-017-2627-4Stroke in a resource-constrained hospital in MadagascarPål Sigurd Stenumgård0Miadana Joshua Rakotondranaivo1Olav Sletvold2Turid Follestad3Hanne Ellekjær4Department of Geriatrics, St. Olavs HospitalFaculty of Medicine, University of AntananarivoDepartment of Geriatrics, St. Olavs HospitalDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Abstract Background Stroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients in a resource-constrained hospital in Madagascar. We also aimed to characterize patients hospitalized with stroke. Methods We registered socio-demographics, clinical characteristics, and early outcomes of patients admitted for stroke between 23 September 2014 and 3 December 2014. We used several validated scales for the evaluation. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS), disability by the modified Rankin Scale (mRS), and function by the Barthel Index (BI). Results We studied 30 patients. Sixteen were males. The median age was 62.5 years (IQR 58–67). The NIHSS and mRS were completed for all of the patients, and BI was used for the survivors. Three patients received a computed tomography (CT) brain scan. The access to laboratory investigations was limited. Electrocardiographs (ECGs) were not performed. The median NIHSS score was 16.5 (IQR 10–35). The in-hospital stroke mortality was 30%. At discharge, the median mRS score was 5 (IQR 4–6), and the median BI score was 45 (IQR 0–72.5). Conclusions Although the access to brain imaging and supporting investigations was deficient, this small-scale study suggests that it is feasible to collect essential data on stroke patients in a resource-constrained hospital in Madagascar. Such data should be useful for improving stroke services and planning further research. The hospitalized stroke patients had severe symptoms. The in-hospital stroke mortality was high. At discharge, the disability category was high, and functional status low.http://link.springer.com/article/10.1186/s13104-017-2627-4StrokeStroke assessment scalesStroke management protocolStroke outcomesMortalityLow-income country |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pål Sigurd Stenumgård Miadana Joshua Rakotondranaivo Olav Sletvold Turid Follestad Hanne Ellekjær |
spellingShingle |
Pål Sigurd Stenumgård Miadana Joshua Rakotondranaivo Olav Sletvold Turid Follestad Hanne Ellekjær Stroke in a resource-constrained hospital in Madagascar BMC Research Notes Stroke Stroke assessment scales Stroke management protocol Stroke outcomes Mortality Low-income country |
author_facet |
Pål Sigurd Stenumgård Miadana Joshua Rakotondranaivo Olav Sletvold Turid Follestad Hanne Ellekjær |
author_sort |
Pål Sigurd Stenumgård |
title |
Stroke in a resource-constrained hospital in Madagascar |
title_short |
Stroke in a resource-constrained hospital in Madagascar |
title_full |
Stroke in a resource-constrained hospital in Madagascar |
title_fullStr |
Stroke in a resource-constrained hospital in Madagascar |
title_full_unstemmed |
Stroke in a resource-constrained hospital in Madagascar |
title_sort |
stroke in a resource-constrained hospital in madagascar |
publisher |
BMC |
series |
BMC Research Notes |
issn |
1756-0500 |
publishDate |
2017-07-01 |
description |
Abstract Background Stroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients in a resource-constrained hospital in Madagascar. We also aimed to characterize patients hospitalized with stroke. Methods We registered socio-demographics, clinical characteristics, and early outcomes of patients admitted for stroke between 23 September 2014 and 3 December 2014. We used several validated scales for the evaluation. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS), disability by the modified Rankin Scale (mRS), and function by the Barthel Index (BI). Results We studied 30 patients. Sixteen were males. The median age was 62.5 years (IQR 58–67). The NIHSS and mRS were completed for all of the patients, and BI was used for the survivors. Three patients received a computed tomography (CT) brain scan. The access to laboratory investigations was limited. Electrocardiographs (ECGs) were not performed. The median NIHSS score was 16.5 (IQR 10–35). The in-hospital stroke mortality was 30%. At discharge, the median mRS score was 5 (IQR 4–6), and the median BI score was 45 (IQR 0–72.5). Conclusions Although the access to brain imaging and supporting investigations was deficient, this small-scale study suggests that it is feasible to collect essential data on stroke patients in a resource-constrained hospital in Madagascar. Such data should be useful for improving stroke services and planning further research. The hospitalized stroke patients had severe symptoms. The in-hospital stroke mortality was high. At discharge, the disability category was high, and functional status low. |
topic |
Stroke Stroke assessment scales Stroke management protocol Stroke outcomes Mortality Low-income country |
url |
http://link.springer.com/article/10.1186/s13104-017-2627-4 |
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