Risk factors of mortality among patients with stroke in eastern region of the democratic republic of Congo: a retrospective cohort study

BACKGROUND: Stroke is a condition of public health concern and it’s a major cause of acquired disability. The rapid and adequate management (diagnosis and multidisciplinary care) and keeping cardiovascular risk factors well-controlled can help to reduce the incidence of stroke-related death. The study aims to identify factors associated with stroke mortality in the Eastern region of the Democratic Republic of Congo. METHODS: This series was retrospectively carried out from 2016 to 2020 in different departments managing stroke patients of the following hospitals of Butembo and Katwa health zones: Katwa Referral Hospital, Kitatumba Referral Hospital, Matanda Hospital, and the Catholic University of Graben Teaching Hospital. Files of patients with the diagnosis of stroke were retrieved and reviewed. The parameters such as socio-demographics, medical history, clinical findings, treatment received, and patients´ mortality outcomes were recorded. The Odds Ratio was used for assessing the risk level attributable to mortality from strokes. Univariate and multivariate analyses were conducted to determine significant predictors of mortality. RESULTS: One hundred and eighty (180) patients with stroke were included. Stroke-related mortality was 57/180 (31.7 %). The factors found to be positively associated with mortality are hemorrhagic stroke (aOR 21.21, 6.2-61.3), reaching hospital (late than 24h aOR 33.8, 16.65-66.6), poor compliance to anti-diabetic medication (aOR 8.46, 3.0-4.3), recurrent stroke (aOR 5.81, 2.0-13.8) poor compliance to antihypertensive (aOR 4.46, 1.4-8.0), and the advanced age >75 years (aOR 6.50, 1.96-21.50). The factor negatively associated with mortality includes being a male (aOR: 0.98, 0.41-2.31). CONCLUSION: Stroke is a common cause of mortality in Butembo. Six management variables remained significant in predicting mortality. These factors, most of which can be modified, should constitute the elements of capacity building by healthcare personnel to significantly reduce this mortality.