Abstract Details

Title Presumed Large Vessel Occlusion in Patients presenting with First-ever Ischemic Stroke at a Tertiary Teaching Hospital in Tanzania

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 115

Objective

We aimed to investigate the burden and outcomes of Large vessel occlusion (LVO) among ischemic stroke patients admitted at a large tertiary hospital in Tanzania.

Background Large vessel ischemic strokes account for more than one-third of all strokes associated with substantial morbidity and mortality without early intervention. The actual incidence of LVO is not known in sub Saharan Africa. Definitive vessel imaging is not routinely available in resource limited settings.

Design/Methods This cohort study recruited all consenting first-ever ischemic stroke participants admitted at a large tertiary hospital in Tanzania. A diagnosis of presumed LVO was made by a neuro-radiologist based on contiguous ischemic changes in a pattern consistent with proximal LVO on non-contrast Computed Tomography head. We examined factors associated with presumed LVO using logistic regression analysis.

Results

We enrolled 158 first-ever ischemic strokes over 8-months with a mean age of 59.7±16.6 years. Presumed LVO accounted for 39.2% [95%CI31.6%-47.3%] with an overall median time of stroke symptoms to hospital arrival of 1 day IQR [1-2]. Participants with presumed LVO were more likely to involve the middle cerebral artery territory (70.9%); p<0.0001. Independent factors on multivariable analysis associated with presumed LVO were: increased waist-hip ratio {adjusted OR 9.31 (95% CI: 2.47–34.99)}, hypertension {adjusted OR 6.74 (95% CI: 2.29–19.85)} and alcohol consumption {adjusted OR 3.97 (95% CI: 1.21–13.00)}. One-year mortality in presumed LVO was 50% compared with 37.5% in participants without presumed LVO.

Conclusions There is a high burden of presumed LVO with high rates of mortality at one year. Further studies utilizing definitive vessel imaging will be key in establishing the actual incidence and for planning preventive and therapeutic strategies in sub Saharan Africa.

Authors/Disclosures
Sarah S. Matuja PRESENTER	Ms. Matuja has nothing to disclose.
Rashid A. Ahmed, MD (Upstate University Hospital)	Dr. Ahmed has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Gustavo J. Rodriguez, MD (Gustavo J. Rodriguez)	Dr. Rodriguez has nothing to disclose.
Alberto Maud, MD (Paul L. Foster School of Medicine Texas Tech UHSC El Paso, Texas)	Dr. Maud has nothing to disclose.
Mohammad Rauf A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
	No disclosure on file
Faheem G. Sheriff, MD (Texas Tech Neurology)	Dr. Sheriff has nothing to disclose.

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