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041			_aEnglish
100			_qSarah Shali Matuja
245			_aPredictors of 30-day mortality among patients with stroke admitted at a tertiary teaching hospital in Northwestern Tanzania _bA prospective cohort study
260			_aMwanza, Tanzania : _bCatholic University of Health and Allied Sciences [CUHAS-Bugando] : _c2023
300			_aPages 01-09
300			_aIncludes References
490			_v Front. Neurol. 13:1100477
520			_aAbstract : Background: Stroke is the second leading cause of death worldwide, with the highest mortality rates in low- to middle-income countries, particularly in sub-Saharan Africa. We aimed to investigate the predictors of 30-day mortality among patients with stroke admitted at a tertiary teaching hospital in Northwestern Tanzania. Methods: This cohort study recruited patients with the World Health Organization's clinical definition of stroke. Data were collected on baseline characteristics, the degree of neurological impairment at admission (measured using the National Institutes of Health Stroke Scale), imaging and electrocardiogram (ECG) findings, and post-stroke complications. The modified Rankin scale (mRS) was used to assess stroke outcomes. Kaplan–Meier analysis was used to describe survival, and the Cox proportional hazards model was used to examine predictors of mortality. Results: A total of 135 patients were enrolled, with a mean age of 64.5 years. Hypertension was observed in 76%, and 20% were on regular anti-hypertensive medications. The overall 30-day mortality rate was 37%. Comparing patients with hemorrhagic and ischemic stroke, 25% had died by day 5 [25th percentile survival time (in days): 5 (95% CI: 2–14)] versus day 23 [25th percentile survival time (in days): 23 (95% CI: 11–30) (log-rank p < 0.001)], respectively. Aspiration pneumonia was the most common medical complication, occurring in 41.3% of patients. ECG abnormalities were observed in 54.6 and 46.9% of patients with hemorrhagic and ischemic stroke, respectively. The most common patterns were as follows: ST changes 29.6 vs. 30.9%, T-wave inversion 34.1 vs. 38.3%, and U-waves 18.2 vs. 1.2% in hemorrhagic and ischemic stroke, respectively. Independent predictors for case mortality were as follows: mRS score at presentation (4–5) [aHR 5.50 (95% CI: 2.02–15.04)], aspiration pneumonia [aHR 3.69 (95% CI: 1.71–13.69)], ECG abnormalities [aHR 2.28 (95% CI: 1.86–5.86)], and baseline stroke severity [aHR 1.09 (95% CI: 1.02–1.17)]. Conclusion: Stroke is associated with a high 30-day mortality rate in Northwestern Tanzania. Concerted efforts are warranted in managing patients with stroke, with particular attention to individuals with severe strokes, ECG abnormalities, and swallowing difficulties to reduce early morbidity and mortality.
600			_x Stroke
600			_xPredictors
600			_xMorbidity
600			_xMortality
600			_x Tanzania
700			_qGilbert Mlay
700			_qFredrick Kalokola
700			_qPatrick Ngoya
700			_qJemima Shindika
700			_qLilian Andrew
700			_qJoshua Ngimbwa
700			_qRashid Ali Ahmed
700			_qBasil Tumaini
700			_qKhuzeima Khanbhai
700			_qReuben Mutagaywa
700			_qMohamed Manji
700			_qFaheem Sheriff
700			_qKarim Mahawish
856			_uhttps://doi.org/10.3389/fneur.2022.1100477 _yhttps://doi.org/10.3389/fneur.2022.1100477
942			_2ddc _cVM _n0
999			_c28033 _d28033