yemenjmedYemen Journal of MedicinecoVolume 1 Issue 2MultidisciplinaryEnglishJuly - December 2022NNY20250328ArticleRisk factors and outcomes of stroke in a tertiary hospital in Hadhramout Governorate, YemenEnglishY6973Jamal MBasamed1EnglishN10.32677/yjm.v1i2.3552Background: Although stroke is a major problem in Hadhramout Governorate, there is a scarcity of reliable information on risk factors of stroke and predictors of in-hospital mortality. The aim of this study was to explore the risk factors and outcomes of stroke patients admitted to Ibn Sina Hospital, Hadhramout, Yemen, and to identify the predictors of in-hospital mortality. Methods and Materials: This retrospective cross-sectional study was conducted in Ibn Sina Hospital in Mukalla district, Hadhramout Governorate, over a 4-month period (from January 1, 2021, to April 30, 2021). Results: During the study period, we recruited 100 cases of stroke, of whom 77 (77%) were male and 23 (23%) were female. Their mean age was 65.42±12.78 years. Hypertension was the most common risk factor, occurring in 81 (81%) patients, while no risk factors were identified in 5 (5%) cases (Cryptogenic). Ischemic stroke was found in 70 (70%) cases, and hemorrhagic stroke was noticed in 30 (30%) patients. The in-hospital mortality was 29 (29%), and the univariate analysis found male sex, hypertension, and hemorrhagic stroke as probable predictors of in-hospital mortality. Only hemorrhagic stroke (adjusted odds ratio [OR]=2.053 and 95% confidence interval [CI]=0.822–1.599; pEnglishHadhramout Governorate, Hemorrhagic stroke, In-hospital mortality, Ischemic stroke, Risk factorshttps://yemenjmed.com/admin/abstract?id=25References16191. Feigin VL. Stroke epidemiology in the developing world. Lancet 200;365:2160-1.2. Eltemamy MA, Tamayo A, Altarsha E, et al. Cerebrovascular risk profiles in a Saudi Arabian cohort of young stroke patients. Front Neurol 2021;12:736818.3. El-Hajj M, Salameh P, Rachidi S, et al. The epidemiology of stroke in the Middle East. Eur Stroke J 2016;1:180-98.4. Roger V, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics 2012 update: A report from the American heart association. Circulation 2012;125:e2-e220.and;nbsp;5. Howard VJ, Cushman M, Pulley L, et al. The reasons for geographic and racial differences in stroke study: Objectives and design. Neuroepidemiology 2005;25:135-43.6. Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circ Res 2017;120:472-95.7. Al-Shenqiti AM. Types and risk factors of first-time stroke: A Saudi hospitalbased study. Int J Physiother 2019;6:118-22.8. World Health Rankings. Available from: https://www.worldlifeexpectancy. com/yemen-stroke#:~:text=Yemen%3A%20Strokeand;amp;text=According%20 to%20the%20latest%20WHO,Yemen%20%2332%20in%20the%20worldand;nbsp;[Last accessed on 2022 Jun 15].9. Sallam A, Al-Aghbari K, Awn H. The clinical profile of stroke: A Yemeni experience. Jordan Med J 2009;43:115-21.10. Bamekhlah RM, Bin-Nabhan AS, Musaian NS. Risk factors and clinical presentation of stroke in Mukalla, Hadhramout, republic of Yemen. Alandalus J Appl Sci 2014;391:40-57.11. Bamekhlah RM, Bamekhlah MR, Al-Ghazali HS, et al. Comparative study between haemorrhagic and ischaemic strokes in Hadramout: A hospital-based study. Hamdan Med J 2019;12:29-33.12. Salah MQ, Aljarmouzi HM, Al-Makdad AM. Prevalence and pattern of stroke among patients attending a teaching hospital in Dhamar governorate, Yemen. Ann Med Health 2019;1:1-4.13. Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association. Stroke 2013;44:2064-89.14. Expert Panel on Detection, Evaluation, and Treatment of High blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 2001;285:2486-97.15. Lutf AQ. COVID-19 in Yemen: The present situation and the future plan to overcome the crisis. Yemen J Med 2022;1:14-6.16. Hezam HS. Knowledge, attitudes, and practices toward COVID-19 among healthcare workers in Shabwah Governorate, Yemen: A cross-sectional study. Yemen J Med 2022;1:31-5.17. Dey G, Jyothi R, Pradeep C, et al. A prospective observational study on prescribing pattern and outcome of acute stroke from a tertiary care hospital in Bengaluru, India. J Clin Diagn Res 2022;16:FC01-5.18. Nour MA, Mrabet S, Maidal MA, et al. Stroke in Djibouti. Afr J Emerg Med 2022;12:141-7.19. Patne SV, Chintale KN. Study of clinical profile of stroke patients in rural tertiary health care centre. Int J Adv Med 2016;3:666-70.20. Mulugeta H, Yehuala A, Haile D, et al. Magnitude, risk factors and outcomes of stroke at debre markos referral Hospital, Northwest Ethiopia: A retrospective observational study. Egypt J Neurol Psychiatry Neurosurg 2020;56:41.21. Jowi J, Mativo P. Pathological sub-types, risk factors and outcome of stroke at the Nairobi hospital, Kenya. East Afr Med J 2008;85:572-81.22. Temesgen TG, Teshome B, Njogu P. Treatment outcomes and associated factors among hospitalized stroke patients at Shashemene referral hospital, Ethiopia. Stroke Res Treat 2018,2018:8079578.23. Khan FY, Yasin M, Abu-Khattab M, et al. Stroke in Qatar: A first prospective hospital-based study of acute stroke. J Stroke Cerebrovasc Dis 2008;17:69-78.24. Qawasmeh MA, Aldabbour B, Momani A, et al. Epidemiology, risk factorsand;nbsp;and predictors of disability in a cohort of Jordanian patients with the first ischemic stroke. Stroke Res Treat 2020;2020:1920583.25. Lahoud N, Abbas MH, Salameh P, et al. A retrospective analysis of 254 acute stroke cases admitted to two university hospitals in Beirut: Classification and associated factors. Funct Neurol 2017;32:41-8.26. Al Harthi HA, Al Kashmiri A, Zakaryia LM, et al. Clinical profile of stroke patients presenting to the emergency department of a major stroke centre in Oman. Sultan Qaboos Univ Med J 2022;22:91-7.27. Al-Mugahed L. Khat chewing in Yemen: Turning over a new leaf. Bull World Health Organ 2008;86:741-2.28. Ali WM, Zubaid M, Al-Motarreb A, et al. Association of Khat chewing with increased risk of stroke and death in patients presenting with acute coronary syndrome. Mayo Clin Proc 2010;85:974-80.29. Al-Motarreb A, Briancon S, Al-Jaber N, et al. Khat chewing is a risk factor for acute myocardial infarction: A casecontrol study. Br J Clin Pharmacol 2005;59:574-81.30. Qureshi AI, Baskett WI, Huang W, et al. Acute ischemic stroke and COVID-19: An analysis of 27 676 patients. Stroke 2021;52:905-12.31. Tu TM, Seet CY, Koh JS, et al. Acute ischemic stroke during the convalescentphase of asymptomatic COVID-2019 infection in men. JAMA Netw Open 2021;4:e217498.32. Siepmann T, Sedghi A, Simon E, et al. Increased risk of acute stroke among patients with severe COVID-19: A multicenter study and meta-analysis. Eur J Neurol 2021;28:238-47.33. Neurology and Neurosurgery: https://www.mayoclinic.org/medicalprofessionals/neurology-neurosurgery/news/proposed-pathogenesisfor-stroke-in-patients-with-covid-19/mac-20529959 [Last accessed on 2022 Jun 29].34. Luo W, Liu X, Bao K, et al. Ischemic stroke associated with COVID-19: A systematic review and meta-analysis. J Neurol 2022;269:1731-40.35. Russell JB, Charles E, Conteh V, et al. Risk factors, clinical outcomes and predictors of stroke mortality in Sierra Leoneans: A retrospective hospital cohort study. Ann Med Surg (Lond) 2020;60:293-300.36. Kamabu LK, Lekuya HM, Kasusula BM, et al. Risk factors of mortality among patients with stroke in eastern region of the democratic republic of Congo: A retrospective series study. PAMJ Clin Med 2021;4:123.