Clinical characteristics and outcomes of patients with stroke admitted to three tertiary hospitals in Zimbabwe: A retrospective one-year study

Background
Epidemiological data on stroke in Zimbabwe are scarce and few clinical studies have been performed to date.
Methods
A retrospective review of the medical records of patients admitted for stroke during the year 2012 was performed at 3 tertiary hospitals in Harare Province (Chitungwiza Central Hospital, Harare Central Hospital, and Parirenyatwa Group of Hospitals). Sociodemographic data were recorded, alongside comorbidities and outcomes. Scoping over a period of 1 year using records of patients admitted for stroke helped to quantify and qualify the stroke problem. Descriptive analysis was done using Stata version 13.0.
Results
A total of 450 stroke cases (63% women) were included in the final analysis. The proportion of stroke cases among the admissions was 0.61%. Mean age of the stroke patients was 61.6 ± 16.8 years (95% CI = 60.1 to 63.2). Risk factors were hypertension (58.5%), diabetes (18%), and HIV, (14%). Diagnosis was clinical and 39.4% had a CT scan. Mean length of hospital stay was 8.1 ± 5.6 days, with a significant difference noted among hospitals (P < 0.001). In-hospital mortality was 24.9% (95% CI = 20.9 to 29.0%). Mortality was associated with place of admission (P < 0.001). There was a significant association between gender and side of stroke (P < 0.001).
Conclusions
The sociodemographic characteristics mirrored findings from elsewhere. Mean age was higher than reported for Zimbabwe in the nineties and more recently in Malawi. The majority of patients were female, elderly, and hypertensive, in line with findings from other countries. The relationship between gender and affected side needs further research. There is need to standardise acute care, through proper diagnosis, to reduce mortality. There is need to support caregivers post-discharge.
Data handling is poor and there is limited capacity for sub-Saharan African hospitals to provide optimal stroke care. This may have long-term implications on the outcome of survivors and caregivers. There is need of vigilance in acute stroke care.