ArticleSouth African family practice : official journal of the South African Academy of Family Practice/Primary Care2023
Clinical review of stroke care at National District Hospital, Bloemfontein.
Article in South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 2 citations in OpenAlex.
- The Ethical Cost of Delay: Lessons From an Acute Haemorrhagic Neurological Emergency in a Low-Resource Setting.Clinical case reports · 2026Article
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3 authors at 1 institution in 1 country.
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Abstract
backgroundStroke is a leading cause of morbidity and mortality affecting sub-Saharan Africa. Studies show that dedicated stroke units improve patient outcomes. National District Hospital (NDH) manages strokes, with the potential of becoming a dedicated stroke unit in Bloemfontein, South Africa. The study aimed to describe the clinical characteristics, management and outcomes of patients presenting with stroke at NDH.
methodsIn this retrospective descriptive study, emergency department registers were used to identify patients presenting with symptoms of a stroke between 01 January 2019 and 31 March 2019. Relevant data were extracted from hospital files.
resultsOf the 106 identified patients, 53 were included in the study. The median age was 61 years (range 28-89 years), with an almost equal split between genders. The most common risk factor was hypertension (81.3%). The median time from symptom onset to presentation at NDH was 9 h. No patient received thrombolysis. One patient received neurosurgical intervention. The most prescribed secondary preventative drugs were antihypertensive medication, statins, anticoagulation and antiretroviral therapy. Half (52.8%) of the patients received rehabilitation as in-patients. Final diagnoses were ischaemic strokes (26/53, 49.0%), transient ischaemic attacks (10/56, 22.7%) and haemorrhagic strokes (6/56, 13.6%). The 6-month post-infarct mortality rate was 37.5%.
conclusionPatient outcomes were comparable to similar South African studies. Time delays in stroke management remain a major obstacle. Identified action points include community education, improving emergency medical services and establishing a dedicated stroke unit.Contribution: This study underlines the importance of stroke and cardiovascular disease prevention and stresses the value of establishing dedicated stroke units.
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