yemenjmedYemen Journal of MedicinecoVolume 2 Issue 3MultidisciplinaryEnglishSeptember-DecemberNNY20231219ArticleClinical presentation, risk factors, and outcomes of stroke in Shabwah Governorate, YemenEnglishY151156Hesham SaeedHezamEnglishNFahmi YousefKhanEnglishY10.32677/yjm.v2i3.4361There is a lack of reliable information on stroke risk factors, clinical presentation, and mortality. The aim of this study was to describe stroke risk factors, clinical presentations, and in-hospital mortality and to identify the independent predictors of mortality among stroke patients admitted to three hospitals in Shabwa Governorate, Yemen. Methods: This retrospective and crosssectional study was conducted from July 1, 2022, to June 30, 2023, in three hospitals in Shabwah Governorate, namely, Shabwah General Hospital Authority, Al Shifa Specialized Hospital, and Afya Specialized Hospital. Results: We involved 124 stroke cases, of whom 92 (74.2%) were males and 32 (25.8%) were females. Their mean age was 64.98±16.22 years, and hypertension was the most common risk factor, accounting for 71.0% (n=88) of cases. Ischemic stroke was detected in 95 (76.6%) cases, intracerebral hemorrhage (ICH) was detected in 25 (20.2%) patients, and subarachnoid hemorrhage (SAH) was detected in 4 (3.2%) cases. The in-hospital mortality was 27(21.8%), and according to bivariate analysis, the in-hospital mortality was significantly associated with hypertension (p=0.015), diabetes mellitus (DM) (pEnglishIntracerebral hemorrhage, Ischemic stroke, Risk factors, In-hospital mortality, Shabwah Governoratehttps://yemenjmed.com/admin/abstract?id=75References16191. Akinyemi RO, Ovbiagele B, Adeniji OA, et al. Stroke in Africa: Profile, progress, prospects and priorities. Nat Rev Neurol 2021;17:634-56.2. Feigin VL. Stroke epidemiology in the developing world. Lancet 2005;365:2160-1.3. Eltemamy MA, Tamayo A, Altarsha E, et al. Cerebrovascular risk profiles in a Saudi Arabian cohort of young stroke patients. Front Neurol 2021;12:736818.4. Katan M, Luft A. Global burden of stroke. Semin Neurol 2018;38:208-11.5. WHO. Available from: https://www.emro.who.int/health-topics/strokecerebrovascular-accident/index.html [Last accessed on 2023 Sep 15].6. Pandian JD, Kalkonde Y, Sebastian IA, et al. Stroke systems of care in lowincome and middle‐income countries: Challenges and opportunities. Lancet 2020;396:1443-51.7. Jacob MA, Ekker MS, Allach Y, et al. Global differences in risk factors, etiology, and outcome of ischemic stroke in young adults-a worldwide metaanalysis: The GOAL initiative. Neurology 2021:98:e573-88.8. 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%20world [Last accessed on 2023 Sep 15].9. Sallam AR, AlAghbari K, Awn H. The clinical profile of stroke: A Yemeni experience. Jordan Med J 2009;43:11521.10. 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, AlGhazali HS, et al. Comparative study between haemorrhagic and ischaemic strokes in Hadramout: Ahospitalbased study. Hamdan Med J 2019;12:29-33.12. Salah MQ, Aljarmouzi HM, Al-Makdad AM, et al. Prevalence and pattern of stroke among patients attending a teaching hospital in Dhamar governorate, Yemen. Ann Med Health 2019;1:1-4.13. Basamed JM. Risk factors and outcomes of stroke in a tertiary hospital in Hadhramout governorate, Yemen. Yemen J Med 2022;1:69-73.14. 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;44:2064-89.15. Oparil S, Acelajado MC, Bakris GL, et al. Hypertension. Nat Rev Dis Primers 2018;4:18014.16. ElSayed NA, Aleppo G, Aroda VR, et al. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care 2023;46:S19-40.17. Nayor M, Vasan RS. Recent update to the US cholesterol treatment guidelines: A comparison with international guidelines. Circulation 2016;133:1795-806.18. Al-Shenqiti AM. Types and risk factors of first time stroke: A Saudi hospitalbased study. Int J Physiother 2019;6:118-22.19. 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:FC1-5.20. Patne SV, Chintale KN. Study of clinical profile of stroke patients in rural tertiary health care centre. Int J Adv Med 2016;3:666-70.21. Arabambi B, Oshinaike O, Akilo OO, et al. Pattern, risk factors, and outcome of acute stroke in a Nigerian university teaching hospital: A 1-year review. Niger J Med 2021;30:252-8.22. Nour MA, Mrabet S, Maidal MA, et al. Stroke in Djibouti. Afr J Emerg Med 2022;12:141-7.23. 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 Psychiatr Neurosurg 2020;56:41.24. Jowi JO, Mativo PM. Pathological sub-types, risk factors and outcome of stroke at the Nairobi hospital, Kenya. East Afr Med J 2008;85:572-81.25. 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;17:69-78.26. Kvitkina T, Narres M, Claessen H, et al. Incidence of stroke in people with diabetes compared to those without diabetes: A systematic review. Exp Clin Endocrinol Diabetes 2023;131:476-90.27. Mosenzon O, Cheng AY, Rabinstein AA, et al. Diabetes and stroke: What are the connections? J Stroke 2023;25:26-38.28. Bonita R, Duncan J, Truelsen T, et al. Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control 1999;8:156-60.29. Pan B, Jin X, Jun L, et al. The relationship between smoking and stroke: A meta-analysis. Medicine (Baltimore) 2019;98:e14872.30. Suryanarayana B, Chirra TR. A study of risk factors and clinical profile of patients with cerebrovascular stroke. J Med Sci Clin Res 2019;7:408-13.31. 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;85:974-80.32. Adoukonou T, Agband;eacute;tou M, Sowanou A, et al. Stroke care and outcomes in the department of neurology in Parakou, Benin: Retrospective cohort study. Ann Med Surg (Lond) 2020;57:148-52.33. 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;60:293-300.34. 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 2020;4:1-11.