Abstract

SMIT, Selma; HAGEMEISTER, Dirk T.  and  VAN ROOYEN, Cornel. Clinical review of stroke care at National District Hospital, Bloemfontein. SAFP [online]. 2023, vol.65, n.1, pp.1-7. ISSN 2078-6204.  http://dx.doi.org/10.4102/safp.v65i1.5608.

BACKGROUND: Stroke is a leading cause of morbidity and mortality affecting sub-Saharan Africa. Studies show that dedicated stroke units improve patient outcomes. National District Hospital (NDH) manages strokes, with the potential of becoming a dedicated stroke unit in Bloemfontein, South Africa. The study aimed to describe the clinical characteristics, management and outcomes of patients presenting with stroke at NDH METHODS: In this retrospective descriptive study, emergency department registers were used to identify patients presenting with symptoms of a stroke between 01 January 2019 and 31 March 2019. Relevant data were extracted from hospital files RESULTS: Of the 106 identified patients, 53 were included in the study. The median age was 61 years (range 28-89 years), with an almost equal split between genders. The most common risk factor was hypertension (81.3%). The median time from symptom onset to presentation at NDH was 9 h. No patient received thrombolysis. One patient received neurosurgical intervention. The most prescribed secondary preventative drugs were antihypertensive medication, statins, anticoagulation and antiretroviral therapy. Half (52.8%) of the patients received rehabilitation as in-patients. Final diagnoses were ischaemic strokes (26/53, 49.0%), transient ischaemic attacks (10/56, 22.7%) and haemorrhagic strokes (6/56, 13.6%). The 6-month post-infarct mortality rate was 37.5% CONCLUSION: Patient outcomes were comparable to similar South African studies. Time delays in stroke management remain a major obstacle. Identified action points include community education, improving emergency medical services and establishing a dedicated stroke unit CONTRIBUTION: This study underlines the importance of stroke and cardiovascular disease prevention and stresses the value of establishing dedicated stroke units

Keywords : stroke; stroke unit; emergency stroke care; neurological outcome; thrombolysis; rehabilitation.

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