Time to death and its determinant factors of stroke patients at Gambella General Hospital, Gambella, Ethiopia.
Stroke
Survival
Survival analysis
Time to death
Journal
European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857
Informations de publication
Date de publication:
09 Sep 2024
09 Sep 2024
Historique:
received:
13
04
2024
accepted:
13
08
2024
medline:
10
9
2024
pubmed:
10
9
2024
entrez:
9
9
2024
Statut:
epublish
Résumé
A stroke or a cerebrovascular accident is a common cause of death and a leading cause of long-term, severe disability in both developed and developing countries. The most recent global burden of disease report states that there were 11.9 million new cases of stroke worldwide; stroke accounts for nearly 1 in 8 deaths globally (12%, 6.5 million deaths) and claims a life every 5 s, making it the second most common cause of death worldwide. The goal of the study was to identify the most important factors influencing stroke patients' time to death at Gambella General Hospital. Data was gathered from patient files in a hospital using a retrospective study methodology, spanning the period from September 2018 to September 2020. R 3.4.0 statistical software and STATA version 14.2 were used for data entry and analysis. The survival time was compared using the log-rank tests and the Kaplan-Meier survival curve. The fitness of the Cox proportional hazard model was examined. The final model that was fitted was the log-logistic AFT model. A statistically significant correlation was defined as having a p value of less than 0.05 and the accelerated factor (γ) with its 95% confidence interval was employed. Eight days was the total median death time (95% CI 6-10). Significant predictors for shortened mortality time were age (γ = 0.94; 95% CI (0.0.920-0.980), hypertension (γ = 0.63; 95% CI (0.605-0.660), and baseline complications (γ = 0.24; 95% CI (0.223-0.256). The shortened timing of death was significantly predicted by age, hypertension, and baseline complications. In light of the study's findings, health administrators and caregivers should work to improve society's overall health.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
A stroke or a cerebrovascular accident is a common cause of death and a leading cause of long-term, severe disability in both developed and developing countries. The most recent global burden of disease report states that there were 11.9 million new cases of stroke worldwide; stroke accounts for nearly 1 in 8 deaths globally (12%, 6.5 million deaths) and claims a life every 5 s, making it the second most common cause of death worldwide. The goal of the study was to identify the most important factors influencing stroke patients' time to death at Gambella General Hospital.
METHODS
METHODS
Data was gathered from patient files in a hospital using a retrospective study methodology, spanning the period from September 2018 to September 2020. R 3.4.0 statistical software and STATA version 14.2 were used for data entry and analysis. The survival time was compared using the log-rank tests and the Kaplan-Meier survival curve. The fitness of the Cox proportional hazard model was examined.
RESULTS
RESULTS
The final model that was fitted was the log-logistic AFT model. A statistically significant correlation was defined as having a p value of less than 0.05 and the accelerated factor (γ) with its 95% confidence interval was employed. Eight days was the total median death time (95% CI 6-10). Significant predictors for shortened mortality time were age (γ = 0.94; 95% CI (0.0.920-0.980), hypertension (γ = 0.63; 95% CI (0.605-0.660), and baseline complications (γ = 0.24; 95% CI (0.223-0.256).
CONCLUSIONS
CONCLUSIONS
The shortened timing of death was significantly predicted by age, hypertension, and baseline complications. In light of the study's findings, health administrators and caregivers should work to improve society's overall health.
Identifiants
pubmed: 39252104
doi: 10.1186/s40001-024-02026-9
pii: 10.1186/s40001-024-02026-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
452Informations de copyright
© 2024. The Author(s).
Références
Johnston SC, Mendis S, Mathers CD. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol. 2009;8(4):345–54.
doi: 10.1016/S1474-4422(09)70023-7
pubmed: 19233730
Collaborators G. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. 2018.
Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(10):3020–35.
doi: 10.1161/STR.0000000000000074
pubmed: 26123479
Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370(9603):1929–38.
doi: 10.1016/S0140-6736(07)61696-1
pubmed: 18063029
Adeloye D, Basquill C. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis. PLoS ONE. 2014;9(8):e104300.
doi: 10.1371/journal.pone.0104300
pubmed: 25090232
pmcid: 4121276
Schütte S, Acevedo PNM, Flahault A. Health systems around the world–a comparison of existing health system rankings. J Glob Health. 2018. https://doi.org/10.7189/jogh.08-010407 .
doi: 10.7189/jogh.08-010407
pubmed: 29564084
pmcid: 5857204
Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245–55.
doi: 10.1016/S0140-6736(13)61953-4
pubmed: 24449944
pmcid: 4181600
Krishnamurthi RV, Feigin VL, Forouzanfar MH, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet Glob Health. 2013;1(5):e259–81.
doi: 10.1016/S2214-109X(13)70089-5
pmcid: 4181351
Deresse B, Shaweno D. Epidemiology and in-hospital outcome of stroke in South Ethiopia. J Neurol Sci. 2015;355(1–2):138–42.
doi: 10.1016/j.jns.2015.06.001
pubmed: 26059446
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The lancet. 2014;384(9945):766–81.
doi: 10.1016/S0140-6736(14)60460-8
Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurol. 2009;8(4):355–69.
doi: 10.1016/S1474-4422(09)70025-0
pubmed: 19233729
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014;384(9945):766–81.
doi: 10.1016/S0140-6736(14)60460-8
pubmed: 24880830
pmcid: 4624264
Greffie ES, Mitiku T, Getahun S. Risk factors, clinical pattern and outcome of stroke in a referral hospital, Northwest Ethiopia. Clin Med Res. 2015;4(6):182–8.
doi: 10.11648/j.cmr.20150406.13
Asres AK, Cherie A, Bedada T, Gebrekidan H. Frequency, nursing managements and stroke patients’ outcomes among patients admitted to Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia a retrospective, institution based cross-sectional study. Int J Afr Nurs Sci. 2020;13:100228.
Mohammed T, Mahmud S, Gintamo B, Mekuria ZN, Gizaw Z. Medication administration errors and associated factors among nurses in Addis Ababa federal hospitals, Ethiopia: a hospital-based cross-sectional study. BMJ Open. 2022;12(12):e066531.
doi: 10.1136/bmjopen-2022-066531
pubmed: 36600356
pmcid: 9730371
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53(282):457–81.
doi: 10.1080/01621459.1958.10501452
Collett D. Modelling survival data in medical research. Boca Raton: CRC Press; 2023.
doi: 10.1201/9781003282525
Muche R. Applied Survival Analysis: Regression Modeling of Time to Event Data. DW Hosmer, Jr., S Lemeshow. New York: John Wiley, 1999, pp. 386, US $89.95. ISBN: 0–471–15410–5. Oxford University Press; 2001.
Collett D. Modelling survival data. In: Collett D, editor. Modelling survival data in medical research. Boston: Springer; 1994. p. 53–106.
doi: 10.1007/978-1-4899-3115-3_3
Schoenfeld D. Partial residuals for the proportional hazards regression model. Biometrika. 1982;69(1):239–41.
doi: 10.1093/biomet/69.1.239
Lemeshow S, May S, Hosmer DW Jr. Applied survival analysis: regression modeling of time-to-event data. Hoboken: John Wiley & Sons; 2011.
Marubini E, Valsecchi MG. Analysing survival data from clinical trials and observational studies. Hoboken: John Wiley & Sons; 2004.
Lee ET, Wang J. Statistical methods for survival data analysis. Hoboken: John Wiley & Sons; 2003.
doi: 10.1002/0471458546
Nelson WB. Recurrent events data analysis for product repairs, disease recurrences, and other applications. Philadelphia: SIAM; 2003.
doi: 10.1137/1.9780898718454
Boersma E, Kertai MD, Schouten O, Bax JJ, Noordzij P, Steyerberg EW, et al. Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index. Am J Med. 2005;118(10):1134–41.
doi: 10.1016/j.amjmed.2005.01.064
pubmed: 16194645
Ababu DG, Getahun AM. Determinants of stroke mortality through survival models: the case of Mettu Karl Referral Hospital, Mettu, Ethiopia. Stroke Res Treat. 2022. https://doi.org/10.1155/2022/9985127 .
doi: 10.1155/2022/9985127
pubmed: 35186250
pmcid: 8856786
Akinyemi RO. Epidemiology of parkinsonism and Parkinson’s disease in Sub-Saharan Africa: Nigerian profile. J Neurosci Rural Pract. 2012;3(03):233–4.
doi: 10.4103/0976-3147.102586
pubmed: 23188965
pmcid: 3505304
Asefa G, Meseret S. CT and clinical correlation of stroke diagnosis, pattern and clinical outcome among stroke patients visting Tikur Anbessa Hospital. Ethiop Med J. 2010;48(2):117–22.
pubmed: 20608015
Allen LA, Stevenson LW, Grady KL, Goldstein NE, Matlock DD, Arnold RM, et al. Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2012;125(15):1928–52.
doi: 10.1161/CIR.0b013e31824f2173
pubmed: 22392529
pmcid: 3893703