Abstract
Background: Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. Methods: This was a hospital-based retrospective cohort which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. Results: The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS -month survival was 37.8%. Conclusion: About one-third of stroke patient were haemorrhagic. Hypertension is the leading CVRF and aetiology of spontaneous ICH. About 1 over 2 patients with SICH would die within 3 months while 50% of survivors would have a poor functional outcome at 6th month.
Highlights
Stroke is a leading cause of mortality and long term disability worldwide [1] [2]
The mean age of female patients with spontaneous intracerebral haemorrhagic (SICH) was 57.3 ± 12.3 years compared to 54.6 ± 11.4 years amongst the male patients and there was no significant difference (Table 1)
Upon arrival at the stroke unit of the Douala General Hospital (DGH), the mean time delay in obtaining CT scan results from time of stroke symptoms onset was 47.20 ± 64.82 hours
Summary
Stroke is a leading cause of mortality and long term disability worldwide [1] [2]. Globally, stroke comprises approximately 10 percent of all deaths and causes 5.5 million deaths each year, with 44 million disability-adjusted life-years (DALYs) lost [3] [4]. The rate of mortality and poor functional recovery amongst patients with SICH is higher compared to those with ischemic stroke [8]. There has been an increase in stroke admission and case-fatality in Cameroon [9]. In Cameroon, SICH accounts for 48% of stroke cases and hypertension (HTN) is the predominant cerebrovascular risk factor [10]. The aim of this study was to determine the epidemiology, describe the clinical profile, aetiology, and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. Our objectives were to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon.
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