Abstract TP193: Epidemiology of Intracerebral Hemorrhage in Qatar

Abstract

Background: Intracerebral hemorrhage (ICH) accounts for 10 to 30 % of all strokes. However, the clinical outcome is worse than ischemic stroke with 50 % mortality rate at 30 days follow up. Qatar has a unique multi-cultural demography which may make the etiology and mechanism of ICH different from the west. There are no reports on the epidemiology of ICH from Qatar. Our study thus aims to evaluate the main risk factors and etiology based on the age and race of our current population. Method: Using our stroke database a retrospective analysis of prospectively collected data of patients with suspected stroke was undertaken . Our study sample included all ICH’s based on head CT imaging and clinical presentation. The etiology of ICH was based on age, risk factors and neurovascular imaging findings. Etiology was classified as: hypertension, CAA, vascular malformation, drug related and others (eg: vasculitis). Baseline characteristics of ICH population were assessed using univariate analysis (χ 2 test, ANOVA & student t test). Multiple logistic regression analysis was performed to define predictors of ICH using SPSS 23 and P value of 0.05 was considered significant. Result: Out of 2525 strokes, 518 (20.5%) were ICH. Patients with ICH were younger with a mean age of 51.72±13.1 compared to ischemic strokes 56.12±13.38. (P value 0.68) Due to the population distribution of races, ICH was more common in the South Asians 201/518 (38.8%) followed by Filipino and Far East [FFE] 96/518 (18.5%), then Nepali 76/518 (14.7%) then Qatari and Arabic population 12% and 9.8% (P < 0.001). The main risk factors for ICH were FFE and Nepali race followed by hypertension, obesity and diabetes. Hypertensive ICH remained the main mechanism across the different races. In the multiple logistic regression analysis, the main predictors of ICH were the FFE race (adjOR: 2.297, CI: 1.77-2.97, P-Value: 0.00) and hypertension (adj OR: 1.85 CI: 1.46-2.36, P-Value: 0.00, NIHSS (adjOR: 1.15 CI: 1.13-1.17, P-value: 0.00) and age (adjOR: 0.9, CI: 0.96-0.98, P-value: 0.00) Conclusion: The rate of ICH in Qatar is similar to the west. It is substantially low in the Qatari’s compared to the Far Eastern and South Asian population. Across all races the main risk factor and etiology remains uncontrolled hypertension.