Ischemic Stroke in Women Admitted in a Tertiary Hospital in Burkina Faso

Abstract

Objective: The objective of this study is to determine the characteristics of ischemic stroke in Women and to compare vascular risk factors, stroke severity and clinical outcome between patients aged under and older 50 years in a tertiary hospital in Burkina Faso. Methodology: We conducted a cross sectional retrospective study on ischemic stroke in adult female patients (≥15 years) admitted in the neurology department of youth from January 1, 2008 to December 31, 2017. Results: During study period, ischemic stroke accounted for 57.6% of all stroke. The mean age of women was of 58.88 (± 17.13) years. About 72.2 % of women was aged over 50 years. Hypertension was the most vascular risk factors (69.7%), followed by dyslipidemia (33.6%) and alcohol consumption (32.7%). Oral contraception pills (8.5%) was the most sex related factors followed by migraine (4.6%) and pregnancy or post-partum state (1.8%). The delay of arrival at emergency department was 4.69 days. At admission, 68% of women had severe neurological deficit (NIHSS ≥ 15). The most common causes of stroke were large vessel disease (37.7%), cardio embolic stroke (20%) and small vessel disease (9.5%). Length of stay was 14.21 days with 15.1% of mortality. Functional outcome at discharge was worse (mRS˃2) in 79.6%of women. After bivariate analysis, hypertension, tobacco use, physical inactivity and diabetes mellitus were most frequent in older women (p=0.0001). Oral contraceptive pill, migraine, HIV and pregnancy were most frequent in young women (p˂0.05). Conclusion: There was a long delay between stroke onset and hospital admission. Hypertension was the most vascular risk factor in older women. The majority of women had severe stroke at admission and worse outcome at discharge.