Pharmacy Practice

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Browsing Pharmacy Practice by Author "Ayele,Teshale(Ass. Prof.)"

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    Clinical Characteristics and Outcomes of Acute ischemic stroke with Atrial fibrillation among patients admitted to Tertiary Care Hospitals in Amhara Regional State: Retrospective-cohort study
    (Addis Ababa University, 2023) Debasu,Zenaw; Ayele,Teshale(Ass. Prof.)
    Background: Atrial fibrillation (AF) is commonly associated with cardioembolic stroke and is the major contributing factor to the increase in hospital expenditures for the care of stroke. However, evidence regarding clinical characteristics and outcomes of patients admitted with acute ischemic stroke (AIS) plus AF in Ethiopia is lacking. Objective: To assess clinical characteristics and outcomes of acute ischemic stroke with atrial fibrillation among patients admitted to Tertiary Care Hospitals in Amhara regional state. Methods: A retrospective cohort study was conducted among patients diagnosed with acute ischemic stroke and treated at Tibebe Ghion and Felege Hiwot CSHs from November 2018 - November 2021. Candidate patients were recruited using a consecutive sampling technique. Data were analyzed using SPSS version 25. Cox-regression analyses was used to identify the predictors of in-hospital mortality. The hazard ratio was used as a measure of the strength of the association and statistical significance was declared at p-value < 0.05. Besides, multivariate linear regression analysis was employed to explore predictors of length of hospital stay. The slope of regression line () with its 95% CI is used to declare statistical significance. Result: Of the 378 patients with acute ischemic stroke, 58.7% were male. AF was diagnosed in 102 (26.9%) patients. Patients with AF were more likely to have Glasgow coma scale <8 (83.3 vs 4%, p< 0.001), valvular heart disease (56.9 vs 4.7 %, p< 0.001), and coronary heart disease (11.8 vs 4%, p=0.005). The incidence rate of in-hospital mortality was high for patients with atrial fibrillation (38 per 1000 person-days vs 17 per 1000 person-days). Glasgow coma scale < 8: (AHR=12.69, 95%CI: 2.603-61.873; p=0.002), Aspirational pneumonia (AHR=2.602, 95%CI: 1.085-6.242; p=0.032), Acute Renal Failure (AHR=6.114, 95%CI: 1.817, 20.576; p=0.003), Hypokalemia: (AHR=1.179, 95%CI: 1.112, 3.373; p=0.013), atrial fibrillation :(AHR=1.104, 95%CI: 1.015, 5.404; p=0.003), HIV/AIDS :(AHR=8.302, 95%CI: 1.585, 43.502 ; p=0.012) and Chronic liver disease :(AHR=4.969, 95%CI: 1.192-20.704 ; p=0.028) were the independent predictors of in-hospital mortality. Besides, deep vein thrombosis (β=7.337, 95%CI: 1.226,13.448; p=0.019), atrial fibrillation (β=1.696, 95%CI: 0.851,2.542; p=0.000), post-stroke depression (β=4.831, 95%CI: 2.330,7.332; p=0.000) and aspiration pneumonia (β=2.089, 95%CI: 1.178,3.000; p=0.000) were predictors of length of stay. IX Conclusion: In this study, hospital mortality was higher in acute ischemic stroke associated with atrial fibrillation. Stroke-related complications were significant predictors of mortality and prolonged length of stay. Hence effective strategies should be in place to curb the impacts of these factors.