Health outcomes after acute ischemic stroke: retrospective and survival analysis from Oman

Abdullah M. Al Alawi; Ikhlas Al Busaidi; Emaad Al Shibli; Al Reem Al-Senaidi; Shahd Al-Manwari; Ibtisam Al Busaidi; Fatema Muhanna; Ahmed Al Qassabi

doi:10.5144/0256-4947.2022.269

Health outcomes after acute ischemic stroke: retrospective and survival analysis from Oman

Abdullah M. Al Alawi^*, Ikhlas Al Busaidi, Emaad Al Shibli, Al Reem Al-Senaidi, Shahd Al-Manwari, Ibtisam Al Busaidi, Fatema Muhanna, Ahmed Al Qassabi

^*Corresponding author for this work

Medicine

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

BACKGROUND: Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.

OBJECTIVES: Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.

DESIGN: Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital.

PATIENTS AND METHODS: All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.

MAIN OUTCOME MEASURES: Functional dependency and factors associated with mortality.

SAMPLE SIZE AND CHARACTERISTICS: 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.

RESULTS: Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.

CONCLUSIONS: Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.

LIMITATIONS: Retrospective at single center.

CONFLICT OF INTEREST: None.

Original language	English
Pages (from-to)	269-275
Number of pages	7
Journal	Annals of Saudi Medicine
Volume	42
Issue number	4
DOIs	https://doi.org/10.5144/0256-4947.2022.269
Publication status	Published - Jan 2022

Keywords

Aged
Female
Humans
Ischemic Stroke
Male
Oman/epidemiology
Outcome Assessment, Health Care
Retrospective Studies
Risk Factors
Stroke
Survival Analysis

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.5144/0256-4947.2022.269

Cite this

@article{6a9293d2920140b78851530bc8207a56,

title = "Health outcomes after acute ischemic stroke: retrospective and survival analysis from Oman",

abstract = "BACKGROUND: Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.OBJECTIVES: Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.DESIGN: Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital.PATIENTS AND METHODS: All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.MAIN OUTCOME MEASURES: Functional dependency and factors associated with mortality.SAMPLE SIZE AND CHARACTERISTICS: 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.RESULTS: Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.CONCLUSIONS: Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.LIMITATIONS: Retrospective at single center.CONFLICT OF INTEREST: None.",

keywords = "Aged, Female, Humans, Ischemic Stroke, Male, Oman/epidemiology, Outcome Assessment, Health Care, Retrospective Studies, Risk Factors, Stroke, Survival Analysis",

author = "{Al Alawi}, {Abdullah M.} and {Al Busaidi}, Ikhlas and {Al Shibli}, Emaad and Al-Senaidi, {Al Reem} and Shahd Al-Manwari and {Al Busaidi}, Ibtisam and Fatema Muhanna and {Al Qassabi}, Ahmed",

note = "Publisher Copyright: Copyright: Copyright {\textcopyright} 2022, Annals of Saudi Medicine, Saudi Arabia.",

year = "2022",

month = jan,

doi = "10.5144/0256-4947.2022.269",

language = "English",

volume = "42",

pages = "269--275",

journal = "Annals of Saudi Medicine",

issn = "0256-4947",

publisher = "Medknow Publications and Media Pvt. Ltd",

number = "4",

}

TY - JOUR

T1 - Health outcomes after acute ischemic stroke

T2 - retrospective and survival analysis from Oman

AU - Al Alawi, Abdullah M.

AU - Al Busaidi, Ikhlas

AU - Al Shibli, Emaad

AU - Al-Senaidi, Al Reem

AU - Al-Manwari, Shahd

AU - Al Busaidi, Ibtisam

AU - Muhanna, Fatema

AU - Al Qassabi, Ahmed

PY - 2022/1

Y1 - 2022/1

N2 - BACKGROUND: Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.OBJECTIVES: Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.DESIGN: Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital.PATIENTS AND METHODS: All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.MAIN OUTCOME MEASURES: Functional dependency and factors associated with mortality.SAMPLE SIZE AND CHARACTERISTICS: 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.RESULTS: Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.CONCLUSIONS: Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.LIMITATIONS: Retrospective at single center.CONFLICT OF INTEREST: None.

AB - BACKGROUND: Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.OBJECTIVES: Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.DESIGN: Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital.PATIENTS AND METHODS: All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.MAIN OUTCOME MEASURES: Functional dependency and factors associated with mortality.SAMPLE SIZE AND CHARACTERISTICS: 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.RESULTS: Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.CONCLUSIONS: Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.LIMITATIONS: Retrospective at single center.CONFLICT OF INTEREST: None.

KW - Aged

KW - Female

KW - Humans

KW - Ischemic Stroke

KW - Male

KW - Oman/epidemiology

KW - Outcome Assessment, Health Care

KW - Retrospective Studies

KW - Risk Factors

KW - Stroke

KW - Survival Analysis

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DO - 10.5144/0256-4947.2022.269

M3 - Article

C2 - 35933604

AN - SCOPUS:85135598838

SN - 0256-4947

VL - 42

SP - 269

EP - 275

JO - Annals of Saudi Medicine

JF - Annals of Saudi Medicine

IS - 4

ER -

Health outcomes after acute ischemic stroke: retrospective and survival analysis from Oman

Abstract

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ASJC Scopus subject areas

UN SDGs

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