Stroke after Hospitalization: Assessment of Functional Prognosis through Disability and Dependency in CNHU-HKM, Cotonou, Benin

2014 
Introduction: Stroke results in severe disability, with impacts that are sometimes socially, emotionally or professionally dramatic and also dramatic for the cost involved in care and treatment. Objective: Assessing the functional prognosis after hospitalization and identifying associated factors. Method: It consisted in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved 100 patients who have known stroke for at least 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Disability and dependency were then measured respectively with the Rankin score and Barthel index. The STATA/IC11.0 statistical software was used as the basis for data analysis. Unvaried and multi-varied analyzes helped to identify associated factors. Results: The overall disability and dependency rates were respectively 69% and 57.7%. And the highest rate of disability (38.8%) was observed between 50 and 60 years old. However, dependency prevalence was higher in subjects above 70 years old (37.3%). Regarding gender, the prevalence of disability was 59.2% in men and rather 41.5% in women. Predictors of disability and dependency were paralysis on admission (IC95% = 0.26 [0.77 - 0.92]; p = 0.036), obesity (IC95% = 0.26 [0.77 - 0.92]; p = 0.012) and monthly income lower than 70$US (IC95% = 0.05 [0.01 - 0.56]; p = 0.015). Conclusion: This study enabled us to assess the functional outcome of patients once discharged. The significance of motor deficit on stroke occurrence, obesity and the low monthly income were factors of poor functional prognosis.
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