Risk Factors for Stroke-Related Functional Disability and Mortality at Felege Hiwot Referral Hospital, Ethiopia

Abstract

Abstract Background Stroke is one of the leading causes of functional disability throughout the globe. A large number of risk factors are measured in stroke disease studies, but it is often unclear whether all of them are relevant variables and whether the impact of these variables changes over time or remains constant with the rate of transition between various states of functional disability in stroke patients.Method From September 2019 to August 2021, 298 randomly chosen adult stroke patients were studied in the medical ward outpatient department at Felege Hiwot Referral Hospital using a retrospective cohort study design. The Modified Rankin Scale is used to assess functional impairment in stroke patients. A multi-state Markov model was used to analyze multi-state repeated events and terminal events in stroke patients with varying levels of functional impairment.Result The probability of transitioning from poor functional ability to death was 10%, and the probability of recovering to good functional ability was 24%. The average time spent in good and poor functional ability for various levels of independent variables differs according to their risk. The hazed ratio for poor in comparison to good functional ability was 1.54, 1.73, 2.34, 2.74, and 1.52 for various levels of sex, age group, hypertension, atrial fibrillation, and types of stroke. In comparison to poor functional ability, the hazed ratio at various levels of diabetes mellitus and atrial fibrillation was estimated to be 1.95 and 3.39 higher risk for death. Furthermore, at various types of stroke and Glasgow coma scale score levels, the hazed ratio was estimated to be 0.58 and 0.77 lower risks for good versus poor functional ability of stroke patients, respectively.Conclusion Since gender and age are unchangeable or difficult to control, the prevention, early detection, and treatment of hypertension, diabetes mellitus, atrial fibrillation, hemorrhage stroke, and severe brain injury had the strongest association with functional disability and decreased survival time among stroke patients. As a result, all levels of staff engaged in stroke must receive immediate training.