Diagnosed diabetes mellitus and in-hospital stroke mortality in a major sub-Saharan African urban medical unit

Alain Zingraff Lekoubou Looti, Nkoke Clovis, Anastase Dzudie, Andre Pascal Kengne

Research output: Contribution to journalArticle

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Abstract

Background Estimates from developed countries show that early mortality after stroke is unaffected by diabetes status. Despite the high burden of both conditions in sub-Saharan Africa, data on the association between diabetes status and early mortality are lacking. Objective In a major referral hospital in the Capital city of Cameroon, among acute stroke patients diagnosed using the World Health Organization criteria, we compared mortality rates in patents with and without known diabetes. Methods Stroke patients with and without known diabetes were compared for demographic characteristics, risk factors, clinical, radiological, laboratory characteristic, and in-hospital mortality. Heterogeneities in mortality rates across major subgroups were investigated via interaction tests, and logistic regression accelerated failure-time models used to adjust for confounders. Results Of the 1667 acute stroke patients included, 213 (12.8%) had diabetes mellitus. In general diabetic patients were older (median age 64.0 vs. 62.0 years, p = 0.0006), and were more likely to have other stroke risk factors including a higher triglyceride levels on admission (106 vs. 97 mg/dL, p = 0.044), a history of stroke (19.7% vs. 13.6%, p = 0.022), and a history of hypertension (89.7% vs. 64.8%, p < 0.0001). The death rates of diabetic patients and that of non-diabetic patients were similar (22.1% vs. 20.1%. p = 0.524). This finding was similar across all pre-specified groups, with no evidence of interaction. Diabetes was unrelated with mortality in adjusted regression models. Conclusion Diabetes is frequent among stroke patients in this setting, and often co-exists with other stroke risk factors. In-hospital mortality rate is equally high in diabetic and non-diabetic patients.

Original languageEnglish (US)
Pages (from-to)57-62
Number of pages6
JournalPrimary Care Diabetes
Volume11
Issue number1
DOIs
StatePublished - Feb 1 2017

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Hospital Mortality
Diabetes Mellitus
Stroke
Mortality
Cameroon
Patents
Africa South of the Sahara
Developed Countries
Triglycerides
Referral and Consultation
Logistic Models
Demography
Hypertension

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

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title = "Diagnosed diabetes mellitus and in-hospital stroke mortality in a major sub-Saharan African urban medical unit",
abstract = "Background Estimates from developed countries show that early mortality after stroke is unaffected by diabetes status. Despite the high burden of both conditions in sub-Saharan Africa, data on the association between diabetes status and early mortality are lacking. Objective In a major referral hospital in the Capital city of Cameroon, among acute stroke patients diagnosed using the World Health Organization criteria, we compared mortality rates in patents with and without known diabetes. Methods Stroke patients with and without known diabetes were compared for demographic characteristics, risk factors, clinical, radiological, laboratory characteristic, and in-hospital mortality. Heterogeneities in mortality rates across major subgroups were investigated via interaction tests, and logistic regression accelerated failure-time models used to adjust for confounders. Results Of the 1667 acute stroke patients included, 213 (12.8{\%}) had diabetes mellitus. In general diabetic patients were older (median age 64.0 vs. 62.0 years, p = 0.0006), and were more likely to have other stroke risk factors including a higher triglyceride levels on admission (106 vs. 97 mg/dL, p = 0.044), a history of stroke (19.7{\%} vs. 13.6{\%}, p = 0.022), and a history of hypertension (89.7{\%} vs. 64.8{\%}, p < 0.0001). The death rates of diabetic patients and that of non-diabetic patients were similar (22.1{\%} vs. 20.1{\%}. p = 0.524). This finding was similar across all pre-specified groups, with no evidence of interaction. Diabetes was unrelated with mortality in adjusted regression models. Conclusion Diabetes is frequent among stroke patients in this setting, and often co-exists with other stroke risk factors. In-hospital mortality rate is equally high in diabetic and non-diabetic patients.",
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Diagnosed diabetes mellitus and in-hospital stroke mortality in a major sub-Saharan African urban medical unit. / Lekoubou Looti, Alain Zingraff; Clovis, Nkoke; Dzudie, Anastase; Kengne, Andre Pascal.

In: Primary Care Diabetes, Vol. 11, No. 1, 01.02.2017, p. 57-62.

Research output: Contribution to journalArticle

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AU - Dzudie, Anastase

AU - Kengne, Andre Pascal

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Y1 - 2017/2/1

N2 - Background Estimates from developed countries show that early mortality after stroke is unaffected by diabetes status. Despite the high burden of both conditions in sub-Saharan Africa, data on the association between diabetes status and early mortality are lacking. Objective In a major referral hospital in the Capital city of Cameroon, among acute stroke patients diagnosed using the World Health Organization criteria, we compared mortality rates in patents with and without known diabetes. Methods Stroke patients with and without known diabetes were compared for demographic characteristics, risk factors, clinical, radiological, laboratory characteristic, and in-hospital mortality. Heterogeneities in mortality rates across major subgroups were investigated via interaction tests, and logistic regression accelerated failure-time models used to adjust for confounders. Results Of the 1667 acute stroke patients included, 213 (12.8%) had diabetes mellitus. In general diabetic patients were older (median age 64.0 vs. 62.0 years, p = 0.0006), and were more likely to have other stroke risk factors including a higher triglyceride levels on admission (106 vs. 97 mg/dL, p = 0.044), a history of stroke (19.7% vs. 13.6%, p = 0.022), and a history of hypertension (89.7% vs. 64.8%, p < 0.0001). The death rates of diabetic patients and that of non-diabetic patients were similar (22.1% vs. 20.1%. p = 0.524). This finding was similar across all pre-specified groups, with no evidence of interaction. Diabetes was unrelated with mortality in adjusted regression models. Conclusion Diabetes is frequent among stroke patients in this setting, and often co-exists with other stroke risk factors. In-hospital mortality rate is equally high in diabetic and non-diabetic patients.

AB - Background Estimates from developed countries show that early mortality after stroke is unaffected by diabetes status. Despite the high burden of both conditions in sub-Saharan Africa, data on the association between diabetes status and early mortality are lacking. Objective In a major referral hospital in the Capital city of Cameroon, among acute stroke patients diagnosed using the World Health Organization criteria, we compared mortality rates in patents with and without known diabetes. Methods Stroke patients with and without known diabetes were compared for demographic characteristics, risk factors, clinical, radiological, laboratory characteristic, and in-hospital mortality. Heterogeneities in mortality rates across major subgroups were investigated via interaction tests, and logistic regression accelerated failure-time models used to adjust for confounders. Results Of the 1667 acute stroke patients included, 213 (12.8%) had diabetes mellitus. In general diabetic patients were older (median age 64.0 vs. 62.0 years, p = 0.0006), and were more likely to have other stroke risk factors including a higher triglyceride levels on admission (106 vs. 97 mg/dL, p = 0.044), a history of stroke (19.7% vs. 13.6%, p = 0.022), and a history of hypertension (89.7% vs. 64.8%, p < 0.0001). The death rates of diabetic patients and that of non-diabetic patients were similar (22.1% vs. 20.1%. p = 0.524). This finding was similar across all pre-specified groups, with no evidence of interaction. Diabetes was unrelated with mortality in adjusted regression models. Conclusion Diabetes is frequent among stroke patients in this setting, and often co-exists with other stroke risk factors. In-hospital mortality rate is equally high in diabetic and non-diabetic patients.

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