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Abstract Details

Assessment of the Prevalence, Risk Factors and Outcomes of Large Vessel Occlusion Strokes at the University Teaching Hospitals, Lusaka, Zambia
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (8:00 AM-9:00 AM)
13-018
To determine the in-hospital prevalence, risk factors, and clinical outcomes of large vessel occlusion strokes (LVOs) at UTH in Lusaka, to identify opportunities for improved acute ischemic stroke management in Zambia.
Stroke burden is rising in Africa, and LVOs, the commonest type of ischemic stroke, have the worst outcomes. Timely intervention improves clinical outcomes. Zambia, like many countries in sub-Saharan Africa, lacks acute ischemic stroke interventions such as thrombolysis and mechanical thrombectomy.
We conducted a longitudinal prospective cohort study of adults with acute stroke (< 7 days) admitted to the largest hospital in Zambia from 2019 to 2022. Demographic, clinical, neuroimaging and outcome data were collected. Descriptive statistics are reported, and associations evaluated using chi-square tests or Fischer’s exact tests as appropriate. Multivariable logistic regression models predicted factors associated with mortality in LVOs.
Of 256 ischemic stroke patients, 64% (n=163) were LVOs. Overall, mean+SD age was 59+17, and 58% were female. Demographic factors (age, sex) and stroke risk factors were similar between those with and without LVOs. Including hypertension (90%), diabetes (23%), hyperlipidemia (19%), previous stroke (17%) and heart disease (29%).  However, the National Institutes of Health Stroke Scale (NIHSS) was significantly higher for LVOs than other ischemic strokes (mean+SD, 16+11 vs 11+8, p<0.001), and modified Rankin Scale scores were worse for LVOs (median (IQR), 4(4,5) vs 4(3,5), p=0.009). In-hospital mortality was higher in LVOs (21% vs 10%, p=0.02). In multivariable analyses, advanced age (OR=1.02, 95% CI 1.004,1.08), higher NIHSS (OR=1.13, 95% CI 1.02,1.26) and tobacco use (OR=5.85, 95%CI 1.36,25.2) were independent predictors of mortality in LVOs.
LVO strokes were the commonest ischemic stroke sub-type in this cohort. They were more severe and associated with higher in-hospital mortality, especially in the elderly. Acute ischemic stroke services are urgently needed to improve stroke outcomes in Zambia.
Authors/Disclosures
Musisye Luchembe
PRESENTER 		Musisye Luchembe has nothing to disclose.
Aparna Nutakki, MD Ms. Nutakki has received research support from UJMT Fogarty Global Health Fellowship Program. Ms. Nutakki has received research support from AAN Medical Student Research Scholarship. Ms. Nutakki has received research support from Gold Humanism Student Summer Fellowship.
Melody T. Asukile, MBBS (University Teaching Hospital) Dr. Asukile has received research support from Royal Society for Tropical Medicine and Hygiene. The institution of Dr. Asukile has received research support from Leverhulme Trust. Dr. Asukile has received personal compensation in the range of $0-$499 for serving as a meeting speaker with American Neurological Association.
Sarah Braun, MD (University Teaching Hospital, Lusaka, Zambia) Sarah Braun has nothing to disclose.
Lorraine Chishimba, MBChB, MMED (University Teaching Hospital) Dr. Chishimba has nothing to disclose.
Mashina Chomba, MBChB (University of Zambia) Dr. Chomba has nothing to disclose.
Meron Gebrewold, MD (Addis Ababa University) Dr. Gebrewold has nothing to disclose.
Mataa Mataa, MD Mataa Mataa has nothing to disclose.
Dominique Mortel, MD (Phoebe Neurology) Dr. Mortel has nothing to disclose.
Mulenga Chilando (University Teaching Hospital) Mulenga Chilando has nothing to disclose.
Dickson Munkombwe, MD (University Teaching Hospital - Adult Hospital) Dr. Munkombwe has nothing to disclose.
Frighton B. Mutete, MBChB (Livingstone University Teaching Hospital) Dr. Mutete has nothing to disclose.
Naluca Mwendaweli, MMED (University Teaching Hospital) NALUCA MWENDAWELI has nothing to disclose.
Coolwe Namangala Dr. Namangala has nothing to disclose.
Faith Simushi, MD (University Teaching Hospital) Dr. Simushi has received research support from American Neurological Association - ANA.
Stanley Zimba, MBBS (University Teaching Hospital) Dr. Zimba has nothing to disclose.
Deanna Saylor, MD, MHS (Johns Hopkins Hospital) Dr. Saylor has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from 好色先生. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and 好色先生al Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.