Prognosis and outcome of acute stroke in the University College Hospital Ibadan, Nigeria

Background: Many factors influence the outcome of acute stroke, the third leading cause of morbidity and mortality globally. Objective: To identify the determinants of outcome of acute stroke. Materials and Methods: A prospectively study of 66 adult patients who presented to the medical emergency unit of University College Hospital (U.C.H), Ibadan, in coma from acute stroke, from August 2004 to March 2005, was undertaken after obtaining ethical clearance and written consent of the patients' relations. Result: Acute stroke constituted 33% of medical coma, 3.2% of hospital emergencies, 1.0% of total hospital admissions, and 7.3% of medical deaths during the study period. The stroke subtypes were intracerebral hemorrhage (78.8%) and large cerebral infarction (21.2%) with respective case fatalities of 69.7% and 13.6% at 4 weeks. Males constituted 75.8% of the patient population with sex-specific mortality of 68.2%. The highest age specific mortality of 65.2% was in the 40-59 years group. The common risk factors were systemic hypertension, obesity, alcohol/substance abuse, and diabetes mellitus. Co-morbidities included aspiration pneumonia, recurrent seizures, hyperglycemia, and sepsis. Conclusion: Age above 39 years, male gender, systemic hypertension, early onset of coma after stroke, and presence of co-morbidities were associated with poor stroke outcome.