Factors Associated with the Occurrence of Medical Complications in the Acute Phase of Stroke in a Reference Hospital at Ouagadougou (Burkina Faso)

Abstract

Introduction: Medical complications are responsible for almost 50% of the causes of death in the acute phase of stroke. The purpose of this study was to identify the factors associated with the occurrence of acute stroke medical complications at the Tingandogo Teaching Hospital in Ouagadougou, Burkina Faso. Patients and Methods: This was a prospective, cross-sectional study of patients admitted to hospital for stroke less than 72 hours from March 2015 to February 2016. Initial general, clinical and paraclinical characteristics and medical complications post stroke, were analyzed. A bivariate and then multivariate analysis with logistic regression, made it possible to identify the independent factors associated with the occurrence of medical complications after stroke. Results: Of the 197 patients enrolled, 63.3% were male; the average age of the patients was 61.1 years; the neurological admission deficit was severe in 30.5%; swallowing disorders were observed in 51.3%. Brain infarctions accounted for 65.5% and haemorrhagic strokes accounted for 34.5%. Broncho-pulmonary infection (42.6%), cardiac complications (25.9%), undernutrition (22.4%), malaria access (17.3%) and urinary tract infection (16.2%). %), were the main medical complications. Neurological deterioration (36%) and epileptic seizures (15.2%) were the observed neurological complications. The independent factors associated with the occurrence of medical complications were: Clinical severity of stroke (NIHSS ≥17) at admission (OR = 3.402, 95% CI 1.27-16.46, p = 0.031); swallowing disorders at admission (OR = 10.19, 95% CI 1.16-89.00, p = 0.000) and co-morbidities (OR = 8.72; 95% CI 1.23- 61.43, p = 0.030). Conclusion: The screening and appropriate management of patients at high risk of medical complications in the acute phase of stroke, in NVUs, will reduce the incidence of these complications and help reduce mortality and disability post stroke.