The Prevalence of Atrial Fibrillation Among Patients With Acute Ischemic Stroke at Kenyatta National Hospital

Abstract

Background: Throughout the world, stroke is graded as the second leading cause of death and the commonest cause of long-term incapacity among adults. Around 80% of all deaths due to stroke occur in underdeveloped nations. The global prevalence of atrial fibrillation (AF) is approximately 0.51%, which translates to about 37,574 million cases. AF patients have an exaggerated risk of heart failure, embolic stroke, lower quality of life, cognitive impairment and higher mortality. AF derives importance from its strong association with ischemic stroke. Objective: To determine the burden of AF among patients with stroke and assess their degree of disability at KNH. Methods: A cross-sectional study conducted at the KNH neurology unit. The prevalence of AF was calculated as proportion of patients with acute ischemic stroke and AF over the total sample size. The comparison of severity of disease between AF and non-AF groups was determined using multinomial regression at 95% confidence interval. Patient clinical and socio-demographic factors associated with AF was determined using independent t-tests for continuous data and chi square test for categorical data. Odds ratio as well 95% confidence interval were calculated. Results: A total of 123 patients with acute ischemic stroke were enrolled for this study. 52.8% were female and the mean age of the enrolled population was 62.4 years. The prevalence of AF in ischemic stroke was found at 29.3%. Majority of those with AF (65%) had moderate to severe disease, while less than 5% of patients without AF has severe disease. Age, smoking, alcohol, marital status, employment, and hypertension were independently associated with the presence of AF. Conclusion: Atrial Fibrillation is a key component known to have a significant impact in stroke occurrence and severity of disease with respect to degree of disability, length of hospital stays as well as mortality. A high prevalence of AF with subsequent impact on mortality was documented in our setup. Special attention and awareness need to be created among health care providers to provide dedicated early diagnostic approaches and treatment among the predisposed groups to prevent the catastrophic outcome.