Table 1 Characteristics of studies on interventions for acute stroke care
From: Interventions for acute stroke management in Africa: a systematic review of the evidence
Lead author year and country | Study aim | Study design | Intervention | Level of evidence | Duration | Population sample | Outcome measures | Key results |
|---|---|---|---|---|---|---|---|---|
Villiers et al. 2009 South Africa | Examine the impact of multidisciplinary stroke care on in-hospital mortality, resource utilisation and access to in-patient rehabilitation facilities for stroke patients admitted to the stroke unit | Retrospective study | Stroke unit | Level 3 | December 2001–February 2002 March 2002–May 2002 | 195 patients Mean age = 58.8 60% were female | Length of hospital stay in-patient death transfer to a tertiary hospital number of patients who accessed CT brain | In-hospital mortality was 31 (33%) in general ward compared to 16 (16%) in the stroke unit (p = 0.005) Mean length of hospital stay before stroke unit was 5.1 (6.5, 3.8–6.4) days compared with 6.8 (4.5, 5.9–7.6) days after stroke unit care (p = 0.01) Access to CT brain scans increased from 13% (12) to 16% (16) Referrals to the tertiary academic hospital 7% (n = 7) vs. 4% (n = 4) did not change significantly |
Wasserman and Bryer 2012 South Africa | To evaluate early outcomes and safety of stroke thrombolysis in a South African setting | Prospective study | Thrombolytic therapy | Level 3 | January 2000–February 2011 | 42 patients | Early neurological recovery functional independence at discharge rate of symptomatic intracranial haemorrhage (SICH) Death | Mean time to t-PA infusion was 160 min (SD 50; range 60–270). 72.5% patients were thrombolysed within 180 min Median NIHSS score fell to 7.5 (IQR 1 to 15) by the time of discharge 67% of patients achieved significant neurological improvement after thrombolysis 40.5% were functionally independent 2 (4·8%) patients suffered SICH 3 (7·1%) patients died at discharge |
Klemperer et al. 2014 South Africa | To evaluate the performance of SITS-SICH and SEDAN scores in predicting the risk of SICH after thrombolysis | Retrospective Study | Thrombolytic therapy | Level 3 | 2000–2012 | 41 patients | Bleeding complications SICH risk | 2 (4.9%) patients experienced SICH, (95% CI: 0–11.5%), SITS-SICH (5.1%) and SEDAN (6.5%) cohorts 23 patients accessed CT brain scan |
Naima Chtaou et al. 2016 Morocco | To report the case series of all patients who were treated with rt-PA in a stroke unit of HASSAN II University hospital between 2010 and 2013 | Case series | Thrombolytic therapy | Level 4 | 2010–2013 | 52 patients mean age = 63 years |  | 17 patients (32.7%) were treated within a 3-h window of stroke onset and 35 (67.3%) within 3–4.5 h 25 patients (48%) had significant early improvements within 24 h, 21 (40.3%) had good outcomes at 3 months and 15 (29%) died Mean door-to-needle time was 75 min and mean onset-to-treatment was 212 min 3 asymptomatic ICH and 4 symptomatic ICHs were reported 2 of the 4 symptomatic ICHs were fatal |