RESUMEN
OBJECTIVE: A recurrent stroke increases the rates of mortality and morbidity after an initial stroke. There is, however, a dearth of data on the prevalence of recurrent stroke in Nigeria. METHODS: A secondary analysis of the data obtained from 100 stroke survivors undergoing physiotherapy at 2 health facilities in Nigeria was carried out to document the prevalence of recurrent stroke. The association between recurrent stroke and selected socio-demographic and clinical factors of the participants was explored using logistic regression analysis. RESULTS: Thirty-two (32%) participants had had a recurrent stroke. Employment status and educational level were significantly associated with recurrent stroke. The outcome of the logistic regression analysis further showed that participants who were employed (OR = 0.08; P<0.001; 95% CI = 0.02-0.32) and who had no formal education (OR = 0.22; P = 0.03; 95% CI = 0.05-0.87) were significantly less likely to present with recurrent stroke compared to the unemployed participants and those who had tertiary educational qualification, respectively. CONCLUSION: Approximately 1 in 3 stroke survivors undergoing rehabilitation had experienced stroke recurrence. The finding of this study buttresses the urgent need to emphasize and aggressively pursue secondary stroke prevention. Further studies are, however, required to explore those potentially modifiable factors that are associated with recurrent stroke, and having more representative samples.
Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/epidemiología , Sobrevivientes , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Estudios Transversales , Escolaridad , Empleo/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Prevalencia , Recurrencia , Factores de Riesgo , Accidente Cerebrovascular/terapia , Adulto JovenRESUMEN
Background Few data on stroke outcomes and no data on stroke recurrence are available in Black mono-racial population with high socio-economic status. Aims We investigated outcomes and stroke recurrence at one year in the Black Afro-Caribbean population of Martinique and examined potential predictors of poor prognosis and recurrence. Methods Patients from ERMANCIA II (Etude Réalisée en MArtinique et Centrée sur l'Incidence des Accidents vasculaires cérébraux), a Black population-based and prospective observational study, were followed up at 28-days, three months and one year post stroke. Stroke characteristics, survival, disability (modified Rankin Scale > 2), and stroke recurrence were assessed. A survival-based approach was used for time-to-event analysis, and multivariable regression analysis assessed the predictors of death, disability and stroke recurrence. Results Of 544 first-ever stroke patients, cumulative risks of death increased from 17.6% (95% confidence interval, 14.5-20.4) at 28 days to 22.8% (18.6-25.0) at three months and to 31.3% (27.4-34.6) at one year. Disability rates in survivors decreased from 43.7% (39.5-47.2) at 28 days to 35% (30.9-38.4) at three months and to 28.8% (24.9-32.1) at one year. Cumulative risks of recurrent stroke were estimated to 2.1% (0.9-2.9) at 28 days, 4.5% (2.7-6.1) at three months and 9.3% (6.1-11.6) at one year. Age (odds ratio (OR), 1.08 (1.05-1.10)), admission NIHSS (OR, 1.22 (1.17-1.29)), metabolic syndrome (OR, 2.07 (1.22-3.52)) and recurrence (OR, 5.06 (1.87-13.7)) were independent predictors of death or disability at one year. Conclusion Stroke Outcomes in Black Afro-Caribbean population with a high socio-economic status appear globally similar to outcomes reported in Caucasian population. After a first-ever stroke, the implementation of early programs of recurrence prevention seems crucial to reduce the risk of poor prognosis at one year.