ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2022
Long-term determinants of death after stroke in Ghana: Analysis by stroke types & subtypes.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- A cardiovascular polypill for secondary stroke prevention in a tertiary centre in Ghana (SMAART): a phase 2 randomised clinical trial.The Lancet. Global health · 2023Trial
- In-hospital survival and predictors of mortality among stroke patients at a tertiary hospital in Ghana: A retrospective cohort study.PloS one · 2026Article
- Mortality rate of stroke and its determinants in Africa: An umbrella review of systematic review and meta-analysis.Global epidemiology · 2025Review
- Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study.Journal of the neurological sciences · 2024Article
- Peripheral blood mononuclear cell low molecular mass protein 7 in acute ischemic stroke: vertical change from admission to discharge and correlation with disability, stroke recurrence, and death.Frontiers in immunology · 2024Article
- Stroke in Sierra Leone: Case fatality rate and functional outcome after stroke in Freetown.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Review
- Survival status and predictors of mortality among adult Stroke patients admitted to Jimma University Medical Center, South west Ethiopia: A retrospective Cohort study.Vascular health and risk management · 2023Article
- Promise of Physiological Profiling to Prevent Stroke in People of African Ancestry: Prototyping Ghana.Current neurology and neuroscience reports · 2022Review
- Differential associations between pre-diabetes, diabetes and stroke occurrence among West Africans.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
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Abstract
backgroundDeterminants of long-term mortality after stroke by mechanistic type and subtype are unknown in sub-Saharan Africa (SSA). Such data are crucial for targeting specific pathophysiologic pathways to improve stroke outcomes in the region. PURPOSE: To evaluate rates and predictors of mortality up to 8 years after stroke, by type and subtype, in Ghana.
methodsWe prospectively collected data on stroke patients presenting at a tertiary medical facility in Ghana between 2013 and 2018 who were followed up until October 31, 2021. Stroke diagnosis was confirmed using a Computerized Tomography scan; ischemic strokes were mechanistically typed using the TOAST classification while intracerebral hemorrhages were subtyped using the SMASH-U scheme. Demographic and clinical predictors of stroke mortality were evaluated using Cox proportional hazards regression modelling.
resultsOf 564 patients encountered during the study period, data on vital status were available for 556 (98.6%) subjects at discharge and 442 (78.4%) on follow-up. Mean age was 61.1 ±15.1 years, and 223 (53.1%) were male. Mortality rates at 1, 3, 12, 36, 60 and 96 months were 37.5%, 43.2%, 49.7%, 57.4%, 62.9%, and 73.7% respectively. Three (3) factors remained significantly associated with risk of death namely age, adjusted hazard ratios (aHR) of 1.12 (95%CI: 1.04-1.20), no formal education 1.36 (95% CI: 1.02-1.81) and modified Rankin score 1.67 (95%CI: 1.42 - 1.98) for each unit rise. For ischemic stroke the four (4) factors associated with long-term mortality were low formal education, low monthly income, having diabetes mellitus and higher functional score on admission. For intracerebral hemorrhage, the two factors were increasing age and high functional score.
conclusionStroke severity is the key predictor of long-term mortality after an index stroke in Ghana, regardless of the underlying pathophysiologic mechanism. Instituting acute stroke systems of care to facilitate timely reperfusion efforts may greatly improve long term survival outcomes after stroke in SSA.
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