ACUTE STROKE PRESENTATION AND OUTCOME-A RETROSPECTIVE DESCRIPTIVE STUDY IN THE SOLOMON ISLANDS

Introduction: Stroke is a major global cause of mortality and morbidity with a high burden of disease in the low to middle income countries. In the Solomon Islands data regarding stroke is limited. The aim of this study is to describe the demography, management and outcome of patients diagnosed with stroke at the National Referral Hospital in the Solomon Islands from January 1st 2018 to December 31st 2018.
Method: This is a retrospective descriptive study of stroke patients admitted under the internal medicine department at the National Referral Hospital. Data from identified eligible patients is entered into IBM SPSS V20 software. Statistical analysis is done using IBM SPSS software.
Results: 70 patients were enrolled, of which 22 (31.4%) died. 53% were women.Mean age was 57.6 +/- 15.9 years. Majority were Melanesians (93%).Hypertension (80%) was common. Significant statistical differences were noted in the respiratory rate and Glasgow coma scale between the survival and mortality groups on triage. The presence of dysphagia, hemiplegia, hemiparesis and seizure were significantly associated with in hospital mortality. Management factors such as delay in feeding, achieving the recommended blood pressure and delay in initiation of feeding contributed to in-hospital mortality. Common cause of death was due to stroke itself and pneumonia was a common complication.
Discussion: The study features the ethnic groups affected by stroke in the country. It also highlights the gaps in management of admitted acute stroke patients and the high in hospital mortality rate indicating the need for standardization of stroke management guidelines within the department as well as consideration for the establishment of a dedicated stroke care unit. The findings of the study emphasize the need for better imaging facilities to differentiate between the different types of stroke and its mimics so that appropriate treatment can be instituted during triage and admission. The study also outline the common medical comorbidities that stroke patients have that are modifiable and demonstrated the need for better awareness and control at the primary care levels. The limitations of this study are that it is retrospective, ingle centered only and the inability to confirm the stroke diagnosis of the study population.