TITLE:
Outcome between Diabetic versus Non-Diabetic Acute Stroke in a Black African Population: A Cohort Study
AUTHORS:
Daniel Gams Massi, Jacques Doumbe, Raïmatou Ngouh Patouokoumche, Chia Mark Ayeah, Caroline Kenmegne, Yacouba Njankouo Mapoure
KEYWORDS:
Diabetes, Prevalence, Mortality, Functional Outcome, Prognosis, Africa
JOURNAL NAME:
World Journal of Neuroscience,
Vol.11 No.3,
August
16,
2021
ABSTRACT: Background: Post-stroke outcomes are poorer in patients
with diabetes mellitus (DM). The aim of this study was to determine the
prevalence of DM in acute stroke and to compare the outcome in patients with or
without diabetes in a tertiary care hospital in Douala, Cameroon. Methods: This
was a hospital-based prospective cohort study included both
diabetic and non-diabetic acute stroke patients (ASP). Demographic,
clinical profile and outcome data was collected within 3 months of stroke
onset. Descriptive statistics, t-test and chi square test used for comparisons
while associations between DM and stroke outcomes, were analyzed using multiple logistic regression and survival analysis. Results:
Of the 701 ASP included, the overall prevalence of diabetes in stroke was 34.2%
(n = 240) while 9.4% (n = 66) had newly diagnosed diabetes. Mortality was
significantly elevated amongst patients with diabetes during hospitalization (p
= 0.034) and at 3 months post stroke onset (p = 0.004), but on multivariate
analysis, diabetes was not an independent predictor of mortality [OR = 0.984;
(95% CI: 0.506 - 1.913); p = 0.961)]. On Cox proportional hazards regression
model, the risk of dying was about 1.5 times higher amongst the DM patients
compared to non-diabetic patients [adjusted HR (95% CI) of 1.502 (1.128 - 2.000);
p = 0.005]. Diabetes was not an independent
predictor of poor functional outcome within 3 months post stroke. Conclusion:
About 1 in 3 ASP had DM on admission. Survival is better in non-diabetes versus
diabetes mellitus ASP. DM was associated with high mortality but does not
influence the functional outcome of ASP in our setting