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Published on: October 22, 2014
Epidemiological Profile and Vascular Risk Factors of Stroke Patients in a Moroccan Provincial Hospital: A
Nadia Mountaj1,2, Anas El Anssari3,4, Mohamed El Assal1
1Department of Nursing Sciences, Higher Institute of Nursing Professions and Health Techniques (ISPITS), Meknes Annex, Fez, Morocco.
Abstract:
Stroke is one of the leading causes of mortality and morbidity worldwide, and its burden is particularly high in low- and middle-income countries. In Morocco, epidemiological data on stroke subtypes, risk factors, symptoms and early outcomes remain limited. The objective of this study was to better understand stroke profiles in Morocco and identify the predictors of haemorrhagic stroke and poor in-hospital prognosis. A retrospective observational study was conducted including 360 patients admitted to Hospital Mohamed V, Meknes, Morocco. Sociodemographic information, vascular risk factor, clinical presentation, stroke subtype and in-hospital outcomes were collected. Comparisons were made among patients with ischaemic stroke, haemorrhagic stroke and transient ischaemic attack (TIA). Multivariate logistic regression analyses were performed to identify the independent predictor of haemorrhagic stroke and separately predictors of poor prognosis among ischaemic stroke patients. Ischaemic stroke was the most prevalent subtype (94.2%), followed by haemorrhagic stroke (4.7%) and TIA (1.1%). The mean age was 67.6 ± 13.0 years. The most common vascular risk factors were hypertension (68.6%), diabetes (35.8%) and cardiopathy (51.4%). Diabetes was more frequent among ischaemic stroke patients, while hypertension characterized all haemorrhagic stroke cases. Male sex independently predicted haemorrhagic stroke (OR = 3.27; 95% CI: 1.11-9.65; p = 0.032). However, diabetes showed a strong inverse association (OR = 0.082; 95% CI: 0.011-0.636; p = 0.017). Overall, in-hospital prognosis for ischaemic stroke was favourable in 86.7% of cases, and sequalae occurred in 6.2% and mortality in 7.1%. Disturbance of consciousness showed a borderline association with poor prognosis (OR = 2.41; 95% CI: 0.93-6.23; p = 0.070). However, age, sex, hypertension, diabetes and cardiopathy were not independent predictors. The findings indicate that most strokes in Morocco are ischaemic and primarily linked to vascular risk factors, particularly hypertension and diabetes. Male sex increases the likelihood of haemorrhagic stroke, while diabetes shifts risk toward ischaemic stroke. Early neurological severity-especially altered consciousness-is the strongest prognostic indicator.
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