Fred S Sarfo1, Joshua Akinyemi2, Albert Akpalu3, Kolawole Wahab4, Joseph Yaria5, Oladimeji Adebayo5, Morenike Komolafe6, Reginald Obiako7, Lukman Owolabi8, Godwin O Osaigbovo9, Carolyn Jenkins10, Yaw Mensah11, Godwin Ogbole12, Benedict Calys-Tagoe13, Philip Adebayo7, Lambert Appiah11, Arti Singh3, Adekunle Fakunle14, Ezinne Uvere14, Tiwari Hemant15, Olayemi Balogun16, Osi Adeleye16, Bimbo Fawale6, Adeniyi Abdulwasiu16, Luqman Ogunjimi17, Onasanya Akinola17, Oyedunni Arulogun14, Arnette Donna18, Okechukwu Ogah5, Rufus Akinyemi19, Bruce Ovbiagele20, Mayowa O Owolabi21. 1. Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com. 2. Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria. 3. Department of Medicine, University of Ghana Medical School, Accra, Ghana. 4. Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria. 5. University College Hospital, Ibadan, Nigeria. 6. Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. 7. Department of Medicine, Ahmadu Bello University, Zaria, Nigeria. 8. Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria. 9. Jos University Teaching Hospital Jos, Nigeria. 10. Medical University of South Carolina, SC, USA. 11. Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 12. Department of Radiology, University of Ibadan, Nigeria. 13. Department of Community Health, University of Ghana Medical School, Accra, Ghana. 14. College of Medicine, University of Ibadan, Nigeria. 15. University of Alabama at Birmingham, Birmingham, AL, USA. 16. Federal Medical Centre, Abeokuta, Nigeria. 17. Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Shagamu, Ogun State, Nigeria. 18. College of Public Health, University of Kentucky, USA. 19. Federal Medical Centre, Abeokuta, Nigeria; Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria. 20. Weill Institute for Neurosciences, School of Medicine, University of California San-Francisco, USA. 21. Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria; Department of Medicine, University of Ibadan, Nigeria. Electronic address: mayowaowolabi@yahoo.com.
Abstract
BACKGROUND: Post-stroke seizures (PSS) are associated with significant morbidity and mortality across the globe. There is a paucity of data on PSS in Africa. PURPOSE: To assess the frequency and factors associated with PSS by stroke types across 15 hospitals in Nigeria and Ghana. METHODS: We analyzed data on all stroke cases recruited into the Stroke Investigative Research and Educational Network (SIREN). We included adults aged ≥18 years with radiologically confirmed ischemic stroke (IS) or intracerebral hemorrhage (ICH). PSS were defined as acute symptomatic seizures occurring at stroke onset and/or during acute hospitalization up until discharge. We used logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. RESULTS: Among 3344 stroke patients, 499 (14.9%) had PSS (95% CI: 13.7-16.2%). The mean duration of admission in days for those with PSS vs no PSS was 17.4 ± 28.6 vs 15.9 ± 24.7, p = 0.72. There were 294(14.1%) PSS among 2091 ischemic strokes and 159(17.7%) among 897 with ICH, p = 0.01. The factors associated with PSS occurrence were age < 50 years, aOR of 1.59 (1.08-2.33), National Institute of Health Stroke Score (NIHSS), 1.29 (1.16-1.42) for each 5 units rise and white cell count 1.07 (1.01-1.13) for each 10^3 mm3 rise. Factors associated with PSS in ischemic were NIHSS score, aOR of 1.17 (1.04-1.31) and infarct volume of 10-30 cm3 aOR of 2.17(1.37-3.45). Among ICH, associated factors were alcohol use 5.91 (2.11-16.55) and lobar bleeds 2.22 (1.03-4.82). CONCLUSION: The burden of PSS among this sample of west Africans is substantial and may contribute to poor outcomes of stroke in this region. Further longitudinal studies are required to understand the impact on morbidity and mortality arising from PSS in Africa.
BACKGROUND: Post-stroke seizures (PSS) are associated with significant morbidity and mortality across the globe. There is a paucity of data on PSS in Africa. PURPOSE: To assess the frequency and factors associated with PSS by stroke types across 15 hospitals in Nigeria and Ghana. METHODS: We analyzed data on all stroke cases recruited into the Stroke Investigative Research and Educational Network (SIREN). We included adults aged ≥18 years with radiologically confirmed ischemic stroke (IS) or intracerebral hemorrhage (ICH). PSS were defined as acute symptomatic seizures occurring at stroke onset and/or during acute hospitalization up until discharge. We used logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. RESULTS: Among 3344 stroke patients, 499 (14.9%) had PSS (95% CI: 13.7-16.2%). The mean duration of admission in days for those with PSS vs no PSS was 17.4 ± 28.6 vs 15.9 ± 24.7, p = 0.72. There were 294(14.1%) PSS among 2091 ischemic strokes and 159(17.7%) among 897 with ICH, p = 0.01. The factors associated with PSS occurrence were age < 50 years, aOR of 1.59 (1.08-2.33), National Institute of Health Stroke Score (NIHSS), 1.29 (1.16-1.42) for each 5 units rise and white cell count 1.07 (1.01-1.13) for each 10^3 mm3 rise. Factors associated with PSS in ischemic were NIHSS score, aOR of 1.17 (1.04-1.31) and infarct volume of 10-30 cm3 aOR of 2.17(1.37-3.45). Among ICH, associated factors were alcohol use 5.91 (2.11-16.55) and lobar bleeds 2.22 (1.03-4.82). CONCLUSION: The burden of PSS among this sample of west Africans is substantial and may contribute to poor outcomes of stroke in this region. Further longitudinal studies are required to understand the impact on morbidity and mortality arising from PSS in Africa.
Authors: M O'Donnell; D Xavier; C Diener; R Sacco; L Lisheng; H Zhang; P Pias; T Truelsen; S L Chin; S Rangarajan; L Devilliers; A Damasceno; C Mondo; F Lanas; A Avezum; R Diaz; J Varigos; G Hankey; P Teal; M Kapral; D Ryglewicz; A Czlonkowska; M Skowronska; P Lopez-Jaramillo; T Dans; P Langhorne; S Yusuf Journal: Neuroepidemiology Date: 2010-04-08 Impact factor: 3.282
Authors: Albert Akpalu; Fred Stephen Sarfo; Bruce Ovbiagele; Rufus Akinyemi; Mulugeta Gebregziabher; Reginald Obiako; Lukman Owolabi; Kwamena Sagoe; Carolyn Jenkins; Oyedunni Arulogun; Sheila Adamu; Lambert T Appiah; Martin A Adadey; Francis Agyekum; Joseph A Quansah; Yaw B Mensah; Abiodun M Adeoye; Arti Singh; Aridegbe O Tosin; Osimhiarherhuo Ohifemen; Abubabkar A Sani; Eric Tabi-Ajayi; Ibinaiye O Phillip; Suleiman Y Isah; Nasir A Tabari; Aliyu Mande; Atinuke M Agunloye; Godwin I Ogbole; Joshua O Akinyemi; Onoja M Akpa; Ruth Laryea; Sylvia Ezinne Melikam; Dorcas Adinku; Ezinne Uvere; Nina-Serena Burkett; Gregory F Adekunle; Salaam I Kehinde; Paschal C Azuh; Abdul H Dambatta; Naser A Ishaq; Donna Arnett; Hemant K Tiwari; Dan Lackland; Mayowa Owolabi Journal: Neuroepidemiology Date: 2015-08-19 Impact factor: 3.282