Predictors and Prognosis of Stroke in Jos, North-Central Nigeria

Stroke is the second leading cause of death worldwide. Stroke mortality has been shown to be higher in blacks in multiracial studies. It is also a very important cause of disability with its attendant deterioration in the quality of life in survivors.

The study sought to determine the risk and prognostic factors associated with stroke in Jos, North Central Nigeria.

A prospective cohort study of stroke patients that were followed up for 90 days to determine outcomes. The stroke patients were admitted into the neurology unit of Jos University Teaching Hospital between September 2016 and August 2018.

We recruited a total of 246 subjects comprising 131 (53.3%) males aged 59.5 ± 13.1 years and 115 (46.6%) females aged 56.7 ± 14.2 years. Obesity, hypertension, dyslipidaemia and alcohol consumption were the commonest risk factors identified. The 90-day case fatality rate of stroke was 22%. Elevated glycated haemoglobin (p = 0.001), loss of consciousness at presentation (p <0.001), atrial fibrillation (p= 0.022), cardiac disease (p < 0.001) and HIV infection (p = 0.001) were significantly associated with poor outcome for stroke. Furthermore, subjects with a high NIHSS had three times the risk of death compared with those with low scores (RR = 2.93; 95% CI = 2.38 - 3.61, p <0.001).

The prognosis of stroke was poor. The predictors of poor stroke outcome were coma, HIV infection, cardiac disease, high NIHSS and total cholesterol.