Analysis Of Stroke Types And Local Risk Factors Among Young People In MULAGO Hospital

Background: According to the World Health Organization’s report on the global burden of disease,stroke is the fifth leading cause of death among people aged 15-59.Stroke in young people is tragic because it can lead to long-term disability,which brings a serious burden to patients,their families,and the whole community.Although the etiology of stroke in young people is relatively clear in developed countries,data on stroke types and risk factors in young people in sub-Saharan Africa are still limited.Therefore,we studied the proportion of stroke types,incidence rate,and risk factors among young adults in MULAGO National Referral Hospital in Uganda through grouping and data analysis.Objective: To determine the type,incidence rate,and risk factors of stroke in young adults attending MULAGO Hospital.Methods: During our study period from January 2021 to September 2022,stroke patients in emergency rooms and general medical wards were recruited consecutively and included in the case group for a case-control study.First,patients with suspected stroke were included according to their clinical manifestations,and then brain CT scanning was performed to exclude tumor,trauma,and other non-vascular factors,and patients meeting the inclusion criteria were classified as ischemic stroke and hemorrhagic stroke.The control group was composed of outpatients who underwent local anesthesia and minor surgery,and the age and gender matched the case group.Descriptive statistical data,including frequency,percentage,mean and standard deviation,are used to compare the clinical,laboratory,and sociodemographic baseline characteristics of the case group and the control group for statistical differences;In order to determine the risk factors of stroke,this study applied conditional logistic regression considering matching(such as age and gender),and odds ratio(95%confidence interval)was used to measure the correlation to evaluate the laboratory characteristics,medical history,or lifestyle between the case group and the control group.The difference between subgroups of the case group,i.e.the proportion of ischemic and hemorrhagic stroke,was evaluated.Results: Among the young adults admitted to Mulago Hospital,most of the stroke cases were ischemic stroke,78 cases(76%),and the other 24 cases(24%)were hemorrhagic stroke.The sex distribution of ischemic stroke was 53.8% in women and 46.2% in men,while that of hemorrhagic stroke was 62.5% in women and 37.5%in men.The average age of stroke patients was 36.4 years(SD=6.2),while that of the control group was 36.3 years(SD=6.4).Independent risk factors for stroke included HIV positive sero-status(OR=3.21(1.09 – 9.49),p=0.035),hypertension(OR=3.94(95%CI: 1.65 – 10.27),p=0.002),abnormal waist hip ratio(OR=3.72(95% CI: 1.66 – 8.32),p=0.001)and abnormal hemoglobin electrophoresis(OR=3.80(95% CI: 1.58 – 9.15),p=0.003).The abnormal fasting blood glucose was associated with a higher risk of stroke in young people,but it was not statistically significant(adjusted OR=2.67(95%CI: 0.70-10.27),p=0.156).There was no significant correlation between stroke and smoking,drinking,illegal drug use,and hyperlipidemia.Conclusion: in young stroke patients,ischemic stroke is higher than hemorrhagic stroke.The risk factors of stroke in young people are hypertension,HIV infection,high waist-hip ratio,and sickle cell disease.Healthcare plans for the prevention and treatment of these factors are needed to reduce the burden of stroke and the related incidence rate and mortality of stroke in this population.