Factors associated with in-hospital case fatality following spontaneous intracerebral hemorrhage among young ghanaians: findings from a hospital-based stroke registry

IF 2.1 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI:10.1016/j.jstrokecerebrovasdis.2026.108568

Priscilla Abrafi Opare-Addo MD, MSCR , Fred Stephen Sarfo MD, PhD, PhD , Minas Aikins MD , Serwaa Asare-Bediako MD , Adwoa Agyemang Adu-Gyamfi MD , Nessya Taylor MD , Emmanuella Naa Ayerki Nartey MD , Maxwell Nyenaah BSc , Jessey Mahama Holu BSc , Samuel Kekeli MPhil , Christian Obirikorang PhD , Francis Agyemang-Yeboah PhD

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Abstract

Background

The incidence of spontaneous Intracerebral Hemorrhage (sICH) in Low-Middle-Income Countries (LMICs) has risen steeply over the past decade, with a relatively earlier age of onset and higher rates of adverse outcomes compared to the rest of the world.

Aim

To determine the factors associated with in-hospital case fatality among patients aged ≤ 50 years with spontaneous Intracerebral Hemorrhage, admitted to a Ghanaian tertiary Hospital.

Methods

We conducted a prospective cohort study among individuals aged 18-50 years admitted with Intracerebral Hemorrhage to Komfo Anokye Teaching Hospital over 2 years, from 2022 to 2023. Multivariable Logistic regression was performed to determine the factors associated with ICH-related case fatality during hospital admission. Survival was compared across categories of explanatory variables using the Kaplan-Meier curve. Predictors of time to death were identified using the Cox regression model.

Results

46.2% (190 out of 411) of all ICH cases were aged ≤ 50 years, with the majority (63.7%) of those affected in this age group being male. The overall case fatality rate among hospitalized patients in this age group was 27.4% (52 out of 190). The factors independently associated with in-hospital case fatality were the presence of aspiration pneumonia (aOR 6.00 (2.47-15.46), p=0.000), NIHSS score at the time of admission (aOR 1.16 (1.08-1.24), p=0.000), and the presence of neuroimaging features of raised intracranial pressure (aOR 2.66 (1.04-7.00), p=0.044). Independent predictors of time to death included the presence of aspiration pneumonia (aOR 3.51 (1.44-8.55), p=0.004) and NIHSS score (aOR 1.07 (1.01-1.13), p=1.27e-08).

Conclusions

Up to 1 in 4 young Ghanaian patients succumb to spontaneous ICH during hospitalization. Prevention, prompt detection, and management of complications, notably aspiration pneumonia during the acute phase of admission, may significantly reduce ICH-related mortality among young individuals in our setting.

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加纳年轻人自发性脑出血后住院病死率相关因素：来自医院卒中登记的发现

背景：在过去十年中，中低收入国家（LMICs）自发性脑出血（sICH）的发病率急剧上升，与世界其他地区相比，自发性脑出血的发病年龄相对较早，不良后果发生率较高。目的：探讨加纳某三级医院收治的年龄≤50岁自发性脑出血患者住院病死率的相关因素。方法：从2022年到2023年，我们在Komfo Anokye教学医院进行了一项为期2年的18-50岁脑出血患者的前瞻性队列研究。采用多变量Logistic分析确定住院期间与脑出血相关病死率相关的因素。使用Kaplan-Meier曲线比较不同类别解释变量的生存率。使用Cox回归模型确定死亡时间的预测因子。结果：411例脑出血患者中46.2%（190例）年龄≤50岁，其中男性占63.7%。该年龄组住院患者的总病死率为27.4%（190人中有52人）。与住院病死率独立相关的因素为吸入性肺炎（aOR 6.00 (2.47 ~ 15.46), p=0.000）、入院时NIHSS评分（aOR 1.16 (1.08 ~ 1.24), p=0.000）、颅内压升高的神经影像学特征（aOR 2.66 (1.04 ~ 7.00), p=0.044）。死亡时间的独立预测因子包括吸入性肺炎（aOR 3.51 (1.44-8.55), p=0.004）和NIHSS评分（aOR 1.07 (1.01-1.13), p=1.27e-08）。结论：高达1 / 4的加纳年轻患者在住院期间死于自发性脑出血。预防、及时发现和处理并发症，特别是入院急性期的吸入性肺炎，可以显著降低我们研究环境中年轻人与ich相关的死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.