Background
Stroke rates are high and rising in low- and middle-income countries. Little is known about stroke in Samoa. The aim of this study was to assess the common risk factors and outcomes of stroke patients admitted to the only stroke capable hospital in Samoa to identify areas for improvement.
Methods
A retrospective study of all stroke patients admitted to Tupua Tamasese Meaole Hospital from 1/1-31/12/2023. We report demographics, risk factors, and outcomes. We conducted regression analysis to measure the associations between risk factors, stroke development, and outcomes.
Results
The study included 69 patients (mean age 61.9 years (SD = 12.7), 42/69 (61%) male). Of these, 46/69 (76%) were ischemic and 23/69 (33.3%) haemorrhagic strokes. Key stroke risk factors included hypertension (77%), diabetes (45%), and a history of previous stroke (13%). Newly diagnosed conditions included hypertension (13/69, 19%), diabetes (4/69, 6%), and atrial fibrillation (9/69, 13%). Fifty-four (78%) patients showed improvement and were alive upon discharge. An important predictor of mortality was Glasgow Coma Scale (GCS) p<0. 0001, OR=1.33), with each additional GCS point increasing the likelihood of improvement and survival by 32.7%. Among the survivors, average length of stay was 5.5 days.
Conclusion
The young age and high rates of hypertension (including new diagnosis rate during hospital stay) and haemorrhages, highlight poor risk factor control, especially hypertension, and emphasise the urgent need for better stroke prevention, screening, and public health interventions. The high post stroke mortality also indicates the need for increased focus on acute stroke case in Samoa.