000			04401nam a22003137a 4500
001			CUHAS/MMED/6000387/T/20
003			CUHAS/MMED/6000387/T/20
005			20240424162916.0
008			231123b |||||||| |||| 00| 0 eng d
028			_bWurzburg Road 35, BMC Premises, Post Code: 33102:
028			_b P. O. Box 1464, Mwanza – Tanzania:
028			_bPhone: +255 28 298 3384:
028			_bFax: +255 28 298 3386:
028			_bEmail: vc@bugando.ac.tz:
028			_b www.bugando.ac.tz
035			_aCUHAS/MMED/6000387/T/20
040			_bEnglish _cDDC
041			_aEnglish
100			_a Mlagwa Lucas Yango _d[Male] _eCUHAS/MMED/6000387/T/20
245			_aThe Prevalence and Factors Associated With Left Atrial Abnormalities among Stroke Patients and 30-Day Outcomes of Stroke Patients Admitted At Bugando Medical Centre and Sekou Toure Regional Referral Hospital
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS – Bugando] : _c2023
300			_a120 Pages
300			_aIncludes References and Appendices
520			_a Abstract: Background: Left atrial abnormality (LAA) is associated with an increased risk of developing stroke and atrial fibrillation, a known risk factor for stroke. Left atrial abnormalities have been proposed to be potential identifiers for developing stroke and atrial fibrillation, particularly paroxysmal atrial fibrillation (PAF) especially those in sinus rhythm. There is limited data on the magnitude of LAA among stroke patients and the factors associated with LAA among stroke patients. Objective. To determine the prevalence and associated factors with LAA and 30-day outcomes of stroke patients admitted at Bugando Medical Center and Sekoutoure Regional Referral Hospital. Methodology. This was a mixed study design (cross-sectional and prospective cohort) that was conducted between October 2022 to April 2023. Consecutive stroke patients aged≥18years were enrolled in the study. A structured questionnaire was used to collect the demographics and clinical characteristics of the patients. A non-contrast computed tomography head was performed on all patients to determine the type of stroke and cardiovascular assessment (electrocardiogram and echocardiogram) to detect the presence of left atrial abnormality. Each participant was followed up for 30 days to determine outcomes. Logistic regression was used to examine baseline factors associated with LAA and Kaplan-Meier analysis was used to describe survival probabilities between the two groups. Results: 405 patients were enrolled, 62.72% were male with a mean age of 65.35±15.2 years, and 91.11% had a history of hypertension. The prevalence of LAA by ECHO and/or ECG was 51.11% among these 19.26% had any ECG LAA and 42.22% had any ECHO LAA. The most common pattern of ECG LAA observed was beat-to-beat p-wave variation and the only pattern of ECHO LAA observed was LAE. Factors associated with LAA were atrial fibrillation (aOR=12,95%CI 4.1-35.3, p-value <0.001), left ventricular hypertrophy (aOR=1.9,95%CI 1.05-3.53, p-value 0.042), dilated cardiomyopathy (aOR=47,95% CI 15.2-148.3, p-value <0.001), age > 60 yrs. (aOR=1.6,95% CI 1.02-2.6, p-value 0.039) and ischemic stroke (aOR=7.1,95%CI 03.7-13.79, pvalue <0.001). The overall mortality was 25.56% among these 62.13% had LAA. Factors associated with mortality were LAA (aOR 3.7 (95% CI 1.74-7.91), p-value <0.001), ischemic stroke (aOR 0.35 (95% CI 0.16-0.734) p-value 0.006), left ventricular hypertrophy (aOR 1.9 (95%CI 1.02-3.52), p-value 0.042), moderate and severe stroke (aOR=3.12 (95% CI 2.04-4.74), p-value <0.001), and a Glasgow coma score of >9 (aOR=0.42 (95%CI 0.24-0.74), p-value <0.003). Conclusions and recommendations: There prevalence of LAA is high, coupled with high mortality at 30 days. The factors associated with LAA were modifiable risk factors and predictors of mortality. The predictors of mortality were the presence of LAA, hemorrhagic stroke, and severe stroke with neurologic impairment. Therefore, we recommend early screening, treatment, and control of risk factors for LAA and stroke and the urgent need of promoting pragmatic interventions to reduce morbidity and mortality from stroke.
600			_xInternal Medicine
700			_aSarah Matuja
700			_a Eva Mujuni
942			_2ddc _cMP _n1
999			_c18783 _d18783