JUNIPER PUBLISHERS-Open Access Journal of Neurology & Neurosurgery
Hospitalized Patients Care Pathway for Stroke and its Determinants in a Reference Hospital in Ouagadougou (Burkina Faso)
Authored by Lompo Djingri Labodi*
Stroke units and intravenous
thrombolysis have been shown to be effective in reducing mortality and post
stroke functional sequelae, but they are still embryonic in sub Saharan Africa.
However, even in developed countries, long hospital and intra hospital delays
still limit their access, hence the interest of a study on the care pathway of
patients hospitalized for stroke and its determinants at the Tingandogo
University Hospital, in Ouagadougound. This was a prospective longitudinal
study of patients consecutively admitted to the Tingandogo University Hospital,
from May 2015 to April 2016, for stroke. Sociodemographic data, cardiovascular
risk factors, comorbidities, clinical and neuroradiological data were analyzed,
as well as the characteristics of the pre- and intra hospital care pathway.
Anunivariate and multivariate analysis was performed. 52 patients (49.5%)
consulted at a health center within ≤3h; 17patients (16.2%) consulted directly
with the CHU medical emergencies; 39 patients (37.1%) received cerebral CT scan
within ≤2h; pre hospital transport by ambulance and the initial clinical
severity of stroke (NIHSS≥17) were independent factors associated with early
first time delay; urban residence was the only independent variable associated
with early admission to emergency departments; vascular risk factors, pre
hospital transport by an ambulance and the initial use of a physician were
independent factors associated with early CT scan. The implementation of an
organized network of pre and intra hospital care centered on the stroke units,
public awareness and training of health professionals on stroke, will reduce
the delays in hospital management of stroke.
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