Evidence map›Paper›PMID 35405450›Full record

ArticleJournal of the neurological sciences2022

Predictors of in-hospital and 90-day post-discharge stroke mortality in Lusaka, Zambia.

Aparna Nutakki, Mashina Chomba, Lorraine Chishimba, Mataa M Mataa, Stanley Zimba, Michelle Kvalsund, Rebecca F Gottesman, Mona N Bahouth, Deanna Saylor

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the neurological sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Aparna NutakkiRush Medical College of Rush University, Chicago, IL, USA.
Mashina ChombaDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Lorraine ChishimbaDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Mataa M MataaChilenje Hospital, Lusaka, Zambia.
Stanley ZimbaDepartment of Internal Medicine, University Teaching Hospital, Lusaka, Zambia.
Michelle KvalsundDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia; Department of Neurology, University of Rochester Medical Center, USA.
Rebecca F GottesmanNational Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, MD, USA.
Mona N BahouthDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Deanna SaylorDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: deanna@jhmi.edu.
University of Zambia · ZMJohns Hopkins University · USNational Institute of Neurological Disorders and Stroke · USRush University · USUniversity Teaching Hospital · ZM

Funding

UJMT – ORWH – Gazzetta, Issa-BoubeD43TW009340 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI William Checkley, Benjamin H. Chi · 2017 to 2026
$14.8M
Adaptation and Implementation of Clinical Practice Guidelines to Improve Stroke Outcomes in ZambiaK01TW011771 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SAYLOR, DEANNA RAE · 2021 to 2025
$1.1M
Community Health and Neuropathy: Nutritional and Environmental Links in Zambia (CHANNELZ)K23NS112463 · NINDS · UNIVERSITY OF ROCHESTER · PI KVALSUND, MICHELLE POWELL · 2020 to 2024
$925k
Understanding hydration and stroke outcomes in ZambiaR21NS118543 · NINDS · JOHNS HOPKINS UNIVERSITY · PI BAHOUTH, MONA N · 2020 to 2021
$354k
FIC NIH HHS D43 TW009340FIC NIH HHS K01 TW011771NINDS NIH HHS K23 NS112463NINDS NIH HHS R21 NS118543
6 · The paper itself

Abstract

backgroundFactors associated with stroke mortality are understudied in sub-Saharan Africa but have implications for designing interventions that improve stroke outcomes. We investigated predictors of in-hospital and 90-day post-discharge stroke mortality in Lusaka, Zambia.

methodsData from consecutive adults admitted with stroke at University Teaching Hospital in Lusaka, Zambia between October 2018 and March 2019 were retrospectively reviewed for clinical in-hospital outcomes. Vital status at 90-days post-discharge was determined through phone calls. Factors associated with stroke mortality were included in multivariable logistic regression models utilizing multiple imputation analysis to determine independent predictors of in-hospital and 90-days post-discharge mortality.

resultsIn-hospital mortality was 24%, and 90-day post-discharge mortality was 22% among those who survived hospitalization. Hemorrhagic and unknown strokes, ICU care, seizures, and aspiration pneumonia were significantly associated with in-hospital mortality. Among these, hemorrhagic stroke (OR 2.88, 95% CI 1.27-6.53, p = 0.01) and seizures (OR 29.5, 95% CI 2.14-406, p = 0.01) remained independent predictors of in-hospital mortality in multivariable analyses. Ninety-day post-discharge mortality was significantly associated with older age, previous stroke, atrial fibrillation, and aspiration pneumonia, but only older age (OR 1.04, 95% CI 1.01-1.06, p = 0.007) and aspiration pneumonia (OR 3.93, 95% CI 1.30-11.88, p = 0.02) remained independently associated with 90-day mortality in multivariable analyses.

conclusionThis Zambian stroke cohort had high in-hospital and 90-day post-discharge mortality that were associated with several in-hospital complications. Our data indicate the need for improvement in both acute stroke care and post-stroke systems of care to improve stroke outcomes in Zambia.

Indexed as

Pneumonia, AspirationStrokeAdultAftercareHospitals, TeachingHumansPatient DischargeRetrospective StudiesSeizuresZambiaIn-hospital mortalityPost-discharge mortalityPredictors of stroke mortalityStroke care delayZambia

Identifiers

PMID35405450
PMCPMC9133219
OpenAlexW4223471317

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.