Fred Stephen Sarfo1, Dominic Otto Awuah2, Clara Nkyi2, John Akassi3, Ohene K Opare-Sem3, Bruce Ovbiagele4. 1. Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Komfo Anokye Teaching Hospital, Kumasi, Ghana. Electronic address: Stephensarfo78@gmail.com. 2. Komfo Anokye Teaching Hospital, Kumasi, Ghana. 3. Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Komfo Anokye Teaching Hospital, Kumasi, Ghana. 4. Medical University of South Carolina, SC, USA.
Abstract
BACKGROUND: Although neurological disorders are projected to escalate globally in the coming decades, there is a paucity of enumerated data on the burden, spectrum and determinants of outcomes of adult neurological admissions in resource-limited settings, especially within sub-Saharan Africa. OBJECTIVE: To evaluate the diversity, demography, and determinants of mortality among adult patients presenting with neurological disorders over a 6-year period in a tertiary medical referral institution in the Central belt of Ghana. METHODS: A retrospective analysis of data on neurological admissions and in-patient outcomes between 2008 and 2013 was undertaken. Data collected for analyses included age, gender, neurological diagnosis, documented comorbidities, duration of admission and vital status at discharge. Predictors of in-patient mortality were evaluated using Kaplan-Meier survival curves and Cox Proportional Hazards regression models. RESULTS: The 6494 admissions with neurological disorders represented 15.0% of all adult medical admissions over the study period. Male-to-female ratio of admissions was 1.6:1.0 with a mean±SD age of 52.9±20 years. The commonest neurological disorders were Cerebrovascular, Infectious, Seizures/epilepsy, Alcohol-use and Spinal cord disorders representing 54.0%, 26.7%, 10.3%, 4.0% and 2.3% of admissions respectively. Despite the low national HIV prevalence of 2.0%, the frequency of HIV infection among patients with infectious disorders of the nervous system was 40.9%. Overall crude mortality rate for neurologic admissions was 30.6% being 39.1% and 33.9% for Infectious affectations of the nervous system and stroke respectively and 7.4% for seizure disorders. Probability of death was higher for females than males aHR (95% CI) of 1.53 (1.40-1.68) and increasing age aHR (95% CI) of 1.11 (1.06-1.17) for each 20-year increase in age. CONCLUSION: Almost one in three patients admitted with neurological disease to a tertiary care center in Ghana died in the hospital, and the majority of these deaths were due to non-communicable conditions. Enhanced multi-dimensional public health disease prevention strategies and neurological inpatient care processes are warranted.
BACKGROUND: Although neurological disorders are projected to escalate globally in the coming decades, there is a paucity of enumerated data on the burden, spectrum and determinants of outcomes of adult neurological admissions in resource-limited settings, especially within sub-Saharan Africa. OBJECTIVE: To evaluate the diversity, demography, and determinants of mortality among adult patients presenting with neurological disorders over a 6-year period in a tertiary medical referral institution in the Central belt of Ghana. METHODS: A retrospective analysis of data on neurological admissions and in-patient outcomes between 2008 and 2013 was undertaken. Data collected for analyses included age, gender, neurological diagnosis, documented comorbidities, duration of admission and vital status at discharge. Predictors of in-patient mortality were evaluated using Kaplan-Meier survival curves and Cox Proportional Hazards regression models. RESULTS: The 6494 admissions with neurological disorders represented 15.0% of all adult medical admissions over the study period. Male-to-female ratio of admissions was 1.6:1.0 with a mean±SD age of 52.9±20 years. The commonest neurological disorders were Cerebrovascular, Infectious, Seizures/epilepsy, Alcohol-use and Spinal cord disorders representing 54.0%, 26.7%, 10.3%, 4.0% and 2.3% of admissions respectively. Despite the low national HIV prevalence of 2.0%, the frequency of HIV infection among patients with infectious disorders of the nervous system was 40.9%. Overall crude mortality rate for neurologic admissions was 30.6% being 39.1% and 33.9% for Infectious affectations of the nervous system and stroke respectively and 7.4% for seizure disorders. Probability of death was higher for females than males aHR (95% CI) of 1.53 (1.40-1.68) and increasing age aHR (95% CI) of 1.11 (1.06-1.17) for each 20-year increase in age. CONCLUSION: Almost one in three patients admitted with neurological disease to a tertiary care center in Ghana died in the hospital, and the majority of these deaths were due to non-communicable conditions. Enhanced multi-dimensional public health disease prevention strategies and neurological inpatient care processes are warranted.
Authors: Fred Stephen Sarfo; Gloria Kyem; Bruce Ovbiagele; John Akassi; Osei Sarfo-Kantanka; Martin Agyei; Elizabeth Badu; Nathaniel Adusei Mensah Journal: J Stroke Cerebrovasc Dis Date: 2016-09-14 Impact factor: 2.136
Authors: Fred Stephen Sarfo; Manolo Agbenorku; Sheila Adamu; Vida Obese; Patrick Berchie; Bruce Ovbiagele Journal: J Neurol Sci Date: 2019-07-23 Impact factor: 3.181
Authors: Fred Stephen Sarfo; Ohene Opare-Sem; Martin Agyei; John Akassi; Dorcas Owusu; Mayowa Owolabi; Bruce Ovbiagele Journal: J Neurol Sci Date: 2018-09-20 Impact factor: 3.181
Authors: Fred S Sarfo; Patrick Berchie; Arti Singh; Michelle Nichols; Maria Agyei-Frimpong; Carolyn Jenkins; Bruce Ovbiagele Journal: J Stroke Cerebrovasc Dis Date: 2019-02-21 Impact factor: 2.136
Authors: Fred Stephen Sarfo; Linda Meta Mobula; Titus Adade; Yvonne Commodore-Mensah; Martin Agyei; Collins Kokuro; Rexford Adu-Gyamfi; Christiana Duah; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-03-04 Impact factor: 3.181