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Masters Thesis | Medicine | Uganda | Volume 12 Issue 6, June 2023
Siriraj Stroke Score Validity in Distinguishing Ischemic from Haemorrhagic Stroke among Patients with Stroke at Saint Francis Hospital in Kampala, Uganda
Salama Kaishusha David | Sylvester Semanda | Maki Sifa Salama | Ingabire Prossie
Abstract: Background: Stroke remains an increasing health problem in Uganda, as the number of hypertensive and diabetic patients rises. It is one of the most devastating diseases, causing gross physical impairment and death. The early and rapid detection of stroke type is very important in mitigating the stroke burden and therefore improving its management. The brain CT-Scan is the Gold Standard tool for stroke diagnosis, but it affordability remains an issue for many patients in Uganda. That is why this study was intended to determine the validity of Siriraj Stroke Score (SSS) in differentiating ischemic from haemorrhagic stroke among adult patients admitted with stroke at St Francis Hospital Nsambya, Kampalain order to help for stoke management and therefore reduce complications. Method: A cross-sectional study was conducted among 138 patients aged eighteen years and above, admitted with stroke at St Francis Hospital Nsambya over a period of twelve months. The data was entered and analyzed in the EPI-INFO version 7 and STATA 13 software. SSS was calculated for each patient and the brain CT scan was also taken and analyse. The results of diagnosis made by Siriraj stroke scoring were compiled and compared with the diagnosis obtained by the brain CT scan. All tests were two-sided and the significance level for all the analyses was set to p <0.05. Results: From the 138 patients admitted with Stroke at St Francis Nsambya Hospital, 68.2% (95% CI: 59.7%-75.4%) had Ischemic Stroke, and 31.8% (95% CI: 24.5%-40.2%) had Hemorrhagic stroke, as per the CT scan reports. From Siriraj Stroke Score, most of patients has Ischemic Stroke 45.65% (95% CI: 37.4%-54.1%), followed by those with Hemorrhagicstoke 42.75% (95%CI: 34.6%-51.2%), and 11.6% (95%CI: 7.1%-18.1%) has an uncertain diagnosis of stroke. The sensitivity and the specificity of SSS was found to be respectively 77.2% and 73.4% in diagnosing hemorrhagic stroke and 63.8% and 93.1% in ischemic stroke. Conclusion: The Siriraj Stroke Score was not sufficiently sensitive in differentiating Ischemic from Hemorrhagic among but can be used to determine ischemic stroke. The CT scan should be made affordable and available to all stroke patients in Uganda, and further studies are mandated to provide large data with discriminating variables, to identify a simple clinical scoring that may help to differentiate clinically, the two major stroke types.
Keywords: Haemorrhagic stroke, Ischemic stroke, Siriraj Stroke Score
Edition: Volume 12 Issue 6, June 2023,
Pages: 1550 - 1556