Article # 11
Stroke Validation Methods in Under- Resourced Ethiopian Hospital Settings
Abstract
Article # 11
Stroke Validation Methods in Under- Resourced Ethiopian Hospital Settings
Authors :
Molla Asnake Kebede , Amenu Tolera Wirtu , Biruk Endalkachew Mekonnen , Abel Girma Tilahun , Tizita Kinfe Degaga , Jickssa Mulissa Gemechu
Keywords :
Stroke , Scores , Validation methods , Ischemia , Haemorrhage
Corresponding Author Contact Information :
Jickssa Mulissa Gemechu Department of Foundational Medical Studies , Oakland University William Beaumont School of Medicine , Rochester , MI , USA Email : gemechu @ oakland . edu
DOI : https :// doi . org / 10.21252 / jyth-qe43
Abstract
In hospitals with active stroke services , diagnosis , and treatment of stroke patients includes computed tomography ( CT ), perfusion imaging and angiography . CT scan is traditionally used to assess patients with suspected intracranial haemorrhage . Yet , it is expensive and inaccessible in most under-resourced hospital settings . In these setups , clinical diagnosis of either haemorrhagic or ischemic stroke might turn out to be inaccurate , and as such , stroke validation techniques need to be addressed within the framework of specific hospital setups . Accordingly , we conducted a prospective cross-sectional study to assess the level of accuracy of clinical stroke validation score methods to distinguish stroke subtypes , including aging-related ischemic stroke patients . CT images generated from 140 participants at Mizan-Tepi University Hospital in Ethiopia were interpreted by a neuroradiologist . Data collection and analysis were done using a patient checklist and SPSS respectively . Findings revealed an incidence of haemorrhagic stroke was 50 %, ischemic stroke was 48.6 % among patients included in the study . The sensitivity , specificity , positive and negative predictive value , and the overall accuracy of Siriraj stroke scores to differentiate haemorrhage from ischemic stroke were , 83.9 %, 68.6 %, 74.6 %, 79.5 %, and 82 %; the Guys stroke scores were 47.8 %, 89.7 %, 73.3 %, 74.5 %, and 74.5 %; the Greek stroke score were 58.8 %, 88.5 %, 87 %, 62.2 %, and 71.6 %; while the Besson stroke scores were 35.3 %, 88.6 %, 75 %, 58.5 %, and 62.3 % respectively . Based on our findings , the Siriraj stroke score showed good sensitivity and fair overall accuracy for haemorrhagic stroke , in under-resource settings . In our stroke validation settings , aging-related cortical atrophy in an 85-year-old female was an impressive finding consistent with the middle cerebral arterial territory of a patient with acute ischemic infarction .