Predictors of Fatal Outcome after Incident of Stroke among Patients from Three Hospitals in Kinshasa, Democratic Republic of the Congo

Abstract

Summary Objective: This study investigated the predictors of stroke fatal outcome after a one year follow-up. Methods: This was a historic cohort of 166 stroke patients from three hospitals in Kinshasa, capital of the Democratic Republic of Congo. Data were collected from patients as they were admitted. Vital outcome information was collected throughout the follow-up period. The Cox proportional hazard modeling was used to measure predictors. Results: The patients’ median age was 59 (IQR: 52-68) years. The majority of them were male (65.1%) and known hypertensive (79.5%). Around 31% patients died within the one year period of follow-up; the median duration between the occurrence of stroke and death was 37 (14-155.5) days. The Glasgow Coma Score and day 7 blood glucose showed a significant influence on vital outcome: an early disorder of consciousness (Glasgow score ˂13) multiplies by 2.5 the risk of death (HR: 2.46, 95% CI [1.3-4.6], p = 0.005) and the glycaemia level at day 7 greater than or equal to 180 mg / dl increases the risk of death by 2.4 times (HR: 2.4, 95% CI [1.03 -5.7], p = 0.04). Conclusion: Hyperglycemia in the acute phase of stroke and early consciousness disorder are predictors of fatal prognosis of stroke, easy to detect in routine clinical practice. They should therefore be used to identify patients with potentially poor prognosis in the short and in the long term for appropriate care.