Abstract:
Background: Stroke is the second leading cause of mortality in the world and the first leading
cardiovascular disease cause of death in sub-Saharan African countries, and stroke-related
deaths accounted for 6.23% of total deaths in Ethiopia. However, there is limited scientific
evidence on survival experience and its predictors among stroke patients in Ethiopia.
Objective: To assess the Survival time of adult stroke patients and its predictors among adult
stroke patients admitted at Jimma University Medical Center from April 1/2017 to March
31/2022.
Method: A retrospective cohort study was conducted on 480 adult stroke patients selected by
simple random sampling among patients admitted to the stroke unit of Jimma University Medical
Center from April 1/2017 to March 31/2022. Data were extracted from May to June 2022,
entered into Epidata version 3.1, and analyzed by the R 4.2 version. Kaplan Meier curve with
Log-rank test was used to estimate survival time and compare survival experience among
categories of explanatory variables. The Cox proportional hazard model’s assumptions were
checked by Schoenfeld residual plot and global test. The Cox regression model was computed to
identify predictors of the survival status of stroke patients. Then the 95% CI of hazard ratio with
corresponding p-value < 0.05 was set to declare statistical significance.
Result: The study involved 480 eligible stroke patients in total, with a mean age of 55.43 ± 14.56
years. During 4350 person-days follow-up; 88(18.33%) patients died; yielding incidence
mortality of 20.23per 1000 person-days, with a median survival time of 38 days. The cumulative
survival rates for the first 7, 14, and 30 days were 0.852, 0.795, and 0.608 respectively. Glasgow
coma scale <8 at admission (AHR= 7.71; 95% CI: 3.78, 15.69), dyslipidemia (AHR =3.96; 95%
CI: 2.04, 7.69), aspiration pneumonia (AHR 2.30; 95%CI: 1.23-4.26) and increased intracranial
pressure (AHR= 4.27; 95% CI: 2.33, 7.81), were the independent predictors of time to death.
Conclusion and Recommendation: The incidence of stroke mortality was higher in the seven
and fourteen days, while the thirty-day mortality and median survival time were lower than in
the previous studies. Glasgow Coma Scale, increased intracranial pressure, dyslipidemia, and
aspiration pneumonia were independent predictors of mortality. Therefore, careful follow-up
and early detection of stroke complications were recommended for unconscious patients.
