Stroke care and outcomes in the Department of Neurology in Parakou, Benin: Retrospective cohort study

Abstract : Introduction: Stroke is one of the most common causes of high mortality rates in Africa with many unknownaspects around its prognosis. In this study we aim to describe stroke characteristics and in-hospital mortality ofstroke in Parakou.Methods: This is a retrospective cohort study including all stroke patients admitted to the Department ofNeurology at Parakou Teaching Hospital from January 1, 2013 through to December 31, 2019. Clinical data,vascular risk factors, stroke subtype and outcome data were recorded. The in-hospital case-fatality and itsassociated factors were determined. The study was approved by the Local Ethics Committee of Biomedicalresearch and has been registered under the unique indentifying number researchregistry5687 and is available athttps://www.researchregistry.com/browse-the-registry#home/Results: Stroke cases represented 51.5% of all patients. There were 372 patients included in the study with a meanage of 58.2 � 14.2 years. The sex ratio was 1:3. Ischemic stroke accounted for 40.3%, intracerebral hemorrhage30.4%, and unknown 29.3%. The main vascular risk factors were hypertension (69.1%), alcoholism (23.9%) anddiabetes mellitus (16.9%). The mean NIHSS at admission was 9.4 � 5.7 and the length of hospital stay was 9.0 �7.3. The most common complications recorded during the acute phase were swallowing disorders (10.2%),pneumonia (9.1%) and urinary tract infections (8.3%). The in-hospital case fatality was 6.2% and was associatedwith loss of consciousness (p ¼ 0.0001), high NIHSS on admission (p ¼ 0.001), fever (p ¼ 0.0001), swallowingdisorders (p ¼ 0.001) and leukocytosis (p ¼ 0.021). On discharge, 27.6% were independent and 97.8% were onantihypertensive drugs.Conclusion: The in-hospital stroke mortality was close to that reported by other studies in Africa.