DETERMINANTS OF STROKE MORTALITY AMONG WEST AFRICANS: FINDINGS FROM THE SIREN STUDY

Stroke is one of the leading causes of death and disability in low-and-medium-income countries, but the pattern and determinants of stroke fatality are yet to be clearly understood among Africans. We assessed the determinants of stroke mortality among adults from 15 sites in Ghana and Nigeria in the Stroke Investigative Research and Educational Network (SIREN) study in West Africa. In this study, 3,739 confirmed stroke cases confirmed with clinical and radiological evidence and stroke fatality status were identified from the SIREN study. Also, data on stroke services and resources were collected for each study site. Logistics regression was applied to estimate the adjusted odds ratio (aOR) and 95% confidence (CI) of mortality post-stroke occurrence at a 2-sided P < 0.05. Overall, 21.8% of all stroke cases enrolled suffered death, and major determinants of stroke mortality were; raised intracranial pressure – ICP (aOR: 3.71, 95%CI: 2.20-6.25), aspiration pneumonia (aOR: 2.70, 95%CI: 1.58-4.59), cerebral decompression therapy (aOR: 1.98, 95%CI: 1.22-3.20), low vegetable consumption (aOR: 1.83, 95%CI: 1.04-3.20) and NIHSS score (aOR: 1.63, 95%CI: 1.44-1.85) for every five (5) units rise. Also, NIHSS score and elevated intracranial pressure and lesion volume >30cm3 (aOR: 2.28, 95%CI: 1.05-4.97) among males, but low vegetable consumption, NIHSS score, raised ICP, aspiration pneumonitis were risk factors for stroke mortality among females Determinants of stroke mortality in this population are multifaceted, but precise interventions targeted at these determinants could significantly lower the burden of stroke mortality among West Africans.