Abstract T P198: Cerebrovascular Disease Patterns among Emergency Room Admissions in 4070 Consecutive Patients of Haiti
Introduction: No study to date has examined cerebrovascular disease patterns in the country of Haiti. Our objective was to describe the patterns of presentation and outcomes of neurological patients presenting to the emergency room (ER) of a major public hospital in Port-au-Prince.
Methods: After obtaining ethical approvals from institutions in the US and in Haiti, de-identified data on neurologic disease were prospectively collected from patients consecutively admitted to the ER of Hôpital de L’Université d’État d’Haïti (HUEH) from November 2012 to January 2013. Data were collected over a period of 90 days using Microsoft Excel, analyzed with standard statistical analysis and is shown as mean±SD.
Results: Out of 4070 consecutive patients, there were 792 neurological admissions (19%; age 42y±20; 40%man). The diagnosis of stroke accounted for 25% of admissions (age 58y±16; 41%man), while hypertensive encephalopathy accounted for 14% (age 49y±16; 30%man). Absence of onsite CT imaging prohibited distinction of ischemic from hemorrhagic stroke in 196 (99%) stroke patients. Data on the time lapse between symptom onset and ER admission was available in 154/197 (78%) of stroke patients. In this group, median and mean time frame were 24-hours and 85±210-hours with 22/134 (16%) presenting in <3-hours and 11/134 (8%) presenting between 3 and 6 hours. The most common presenting symptom among patients with hypertensive encephalopathy was headache (73%); the average presenting blood pressure (BP) in this group was systolic 174±27mmHg and diastolic 108±24mmHg. The most common presenting symptoms among stroke patients included speech disturbance (47%), and altered mental status (56%). Overall in-hospital stroke mortality was 19% (38/197).
Conclusions: To our knowledge, this is the first study addressing cerebrovascular disease patterns in Haiti. Limitations on diagnostic imaging and resources contribute to high observed morbidity and mortality. Prevention, diagnosis, and treatment of cerebrovascular diseases should be prioritized in Haiti, while additional studies are necessary to better define the epidemiology of this disease.
Author Disclosures: E. Barthelemy: None. M.Y.E. Jean-Pierre: None. E. Benjamin: None. L. Télémaque: None. B. Pierre: None. I. Osborn: None. I. Germano: None.
- © 2014 by American Heart Association, Inc.