Profile and determinants of acute stroke outcome: a prospective cohort study in a tertiary healthcare facility in Makurdi, North Central Nigeria.

Introduction: stroke remains a major cause of morbidity and mortality, particularly in low-resource settings. This study assessed the profile and determinants of outcome in acute stroke patients in a tertiary health care facility in Makurdi, North Central Nigeria. Methods: a prospective cohort study was conducted between April 2021 and August 2022 at the Benue State University Teaching Hospital, Makurdi. Consecutively admitted patients (≥18 years) with acute stroke were recruited and assessed using a structured questionnaire and the Modified Rankin Scale (mRS). Descriptive statistics were used to compute the mean and standard deviation for age, while multivariable regression analysis was done to determine factors associated with mortality. Results: out of 105 patients, 80.0% (n=84) were aged ≥50 years (mean = 60 ± 13), and 58.1% (n=61) were male. Ischaemic stroke was more frequent, 78.1% (n=82), than hemorrhagic stroke, 21.9% (n=23). Hypertension, 74.3% (n=78), and diabetes, 36.2% (n=38) were the leading risk factors. The case fatality rate was 37.1% (n=39), while 55.3% (n=58) improved and were discharged. A good outcome (mRS 0-3) was achieved in 46.7% (n=49) of the subjects. Multivariate analysis revealed that vomiting (aOR: 11.55, 95% CI 1.65-80.71; p=0.014), unsteady gait (aOR: 12.93, 95% CI 1.27-132.22; p=0.031), and cognitive impairment (aOR: 7.42, 95% CI 1.46-37.87; p=0.016) markedly increased the likelihood of death. Conclusion: the majority of stroke patients in Makurdi suffered an ischaemic stroke type, and had hypertension as the main risk factor, with a case fatality rate of 37.1%. Furthermore, vomiting, unsteady gait, and cognitive impairment were strongly associated with death as an outcome.