HIGH PREVALENCE OF ATRIAL FIBRILLATION IN STROKE PATIENTS ADMITTED TO UNIVERSITY OF GONDAR HOSPITAL, NORTHWEST ETHIOPIA

Authors

  • Ermias Shenkutie Greffie University of Gondar
  • Taddese Mitiku University of Gondar
  • Seid Getahun University of Gondar

Abstract

Purpose : Even though atrial fibrillation  is a common risk factor of stroke which contributes to poor outcome, data concerning this association is scarce in African countries. This study assessed the prevalence of confirmed atrial fibrillation and its effect on outcome in stroke patients admitted to University of Gondar Hospital.

Methods: A Hospital based cross-sectional study by record analysis was done from December 2014 to February 2015. All adult stroke patients with documented head CT scan and ECG results admitted to university of Gondar hospital during June 2010 to May 2013 were included. Relevant data including sociodemographics, type of stroke, and presence of atrial fibrillation was collected from patient charts using a data extraction form.

Results: A total of 94 patients with mean age of 67.4±12.4 years and Female to male ratio of 1.13:1 were analyzed. The prevalence of AF was 28.7%. It occurred in 34% and 14% of ischemic and hemorrhagic strokes respectively. The in hospital case fatality of stroke associated with and without atrial fibrillation was 22.2% and 8% respectively while the rate of improvement at discharge was 34% and 68% respectively. Atrial fibrillation was associated with a low rate of improvement at discharge (OR= 0.28 CI: 0.1-0.78).

Conclusion: Atrial fibrillation is common in stroke patients in our hospital, especially in the elderly population. It is associated with low rate of improvement at discharge. Appropriate screening and treatment of atrial fibrillation is invaluable for the primary and secondary prevention of stroke.

Keywords: cerebrovascular accident, cardiac disease, electrocardiography, anticoagulation

Author Biographies

Ermias Shenkutie Greffie, University of Gondar

Assistant professor, Department of Internal Medicine

Taddese Mitiku, University of Gondar

Lecturer, Department of Internal Medicine

Seid Getahun, University of Gondar

Lecturer, Department of Internal Medicine

References

Feigin VL, Lawes CM, Bennett DA, et al. Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet neurology. 2003;2(1):43-53.

Connor MD, Walker R, Modi G, et al. Burden of stroke in black populations in sub-Saharan Africa. Lancet Neurol. 2007;6(3):269-278.

Saposnik G, Gladstone D, Raptis R, et al. Atrial fibrillation in ischemic stroke predicting response to thrombolysis and clinical outcomes. Stroke. 2013;44(1):99-104.

Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Annals of internal medicine. 2007;146(12):857-867.

Sandercock P, Bamford J, Dennis M, et al. Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project). BMJ (Clinical research ed). 1992;305(6867):1460-1465.

Jorgensen HS, Nakayama H, Reith J, et al. Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke. 1996;27(10):1765-1769.

Lamassa M, Di Carlo A, Pracucci G, et al. Characteristics, Outcome, and Care of Stroke Associated With Atrial Fibrillation in Europe Data From a Multicenter Multinational Hospital–Based Registry (The European Community Stroke Project). Stroke. 2001;32(2):392-398.

Gladstone DJ, Spring M, Dorian P, et al. Atrial fibrillation in patients with cryptogenic stroke. New England Journal of Medicine. 2014;370(26):2467-2477.

Sridharan SE, Unnikrishnan J, Sukumaran S, et al. Incidence, types, risk factors, and outcome of stroke in a developing country the trivandrum stroke registry. Stroke. 2009;40(4):1212-1218.

Atadzhanov M, Mukomena PN, Lakhi S, et al. Stroke Characteristics and Outcomes of Adult Patients Admitted to the University Teaching Hospital, Lusaka, Zambia. Open General and Internal Medicine Journal. 2012;5:3-8.

Zenebe G, Alemayehu M, Asmera J. Characteristics and outcomes of stroke at Tikur Anbessa Teaching Hospital, Ethiopia. Ethiop Med J. 2005;43(4):251-259.

Marini C, De Santis F, Sacco S, et al. Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a population-based study. Stroke. 2005;36(6):1115-1119.

Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation. The Framingham Study. Stroke. 1996;27(10):1760-1764.

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Published

2016-09-23

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Original Article