Neuroimaging Findings and Their Prognostic Value in Acute Ischaemic Stroke Patients at University of Maiduguri Teaching Hospital (UMTH), Borno State, Nigeria.

Background: Accurate prediction of stroke outcomes in resource-limited settings remains challenging. This study assessed the utility of neuroimaging findings in predicting mortality among acute ischaemic stroke patients at the University of Maiduguri Teaching Hospital, Nigeria.

Methodology: This prospective study enrolled 171 consecutive adults with acute ischaemic stroke between January and December 2023. All patients underwent non-contrast brain CT scanning, with infarct volume calculated using standardized measurements. The primary outcome was 30-day mortality. Multivariate logistic regression analysis identified independent predictors of mortality, which were used to develop a risk stratification system.

Results: Large infarct volume (>100,000 mm³) emerged as the strongest independent predictor of mortality (aOR 6.82, 95% CI 2.0522.68, p=0.002), followed by multiple territory involvement (aOR 3.42, 95% CI 1.43-8.17, p=0.006). The developed risk score demonstrated good discriminative ability (AUC 0.775, 95% CI 0.689-0.860) and stratified patients into three risk categories with mortality rates of 8.2% (low), 11.8% (intermediate), and 42.0% (high) (p<0.001).

Conclusion: Specific neuroimaging parameters can effectively predict early mortality in acute ischaemic stroke. The developed risk stratification tool could improve patient care in resource-limited settings.