Title:Management of Acute Stroke Among Lebanese Patients: Assessing Adherence
to International Guidelines
Volume: 18
Issue: 4
Author(s): Diana Malaeb, Sarah Cherri*, Iqbal Fahs, Hala Sacre, Emane Abdallah, Pascale Salameh and Hassan Hosseini
Affiliation:
- School of Pharmacy, Institut
National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
Keywords:
Mortality, hypertension, adherence, acute stroke, Lebanese patients, ischemic stroke.
Abstract:
Background: Ischemic stroke accounts for around 87% of all strokes worldwide and is
the second leading cause of mortality and a significant factor of disability in adults. The objective
of this study was to assess the adherence to international treatment guidelines for ischemic stroke
in Lebanese hospitals and evaluate factors associated with in-hospital mortality.
Methods: This retrospective observational study was conducted in three Lebanese hospitals between
January 2018 and December 2019. All adult patients diagnosed with ischemic stroke and
who were subsequently admitted and treated in the internal medicine department, intensive care
unit, or coronary care units were included in the study.
Results: Out of 292 patients with stroke, 56.8% were females with hypertension being the most
common previous disease (38.4%). Concerning acute management, 94.5% had an early brain imaging
performed upon hospital presentation, 14.4% were eligible for emergency reperfusion, 2.1%
were prescribed fibrinolytic therapy, 50% were adherent with acute hypertension treatment, and
6.2% were adherent with the antiplatelet regimen recommendation. The results highlight that right
sided hemiparesis, decreased level of consciousness, and hyperthermia (T > 38°C) were significantly
associated with in-hospital death. Guideline adherence for all the acute treatment measures
and management strategies was 90.2%.
Conclusion: The study highlights that guideline recommendations were not uniformly applied
among all patients, and those recommendation standards set by the guidelines were not applied
among all hospitals.
