Factors Associated With Mortality Among Adult Hemorrhagic Stroke Patients in Public Hospitals in the Harari Region, Eastern Ethiopia: A Retrospective Hospital-Based Cohort Study.

BACKGROUND

A hemorrhagic stroke is a life-threatening emergency that can lead to disability or death without prompt treatment. However, there is limited evidence on factors associated with mortality in hemorrhagic stroke, particularly in eastern Ethiopia. Therefore, this study is aimed at assessing the factors associated with mortality among adult hemorrhagic stroke patients in the Harari region, eastern Ethiopia.

METHODOLOGY: A retrospective cohort study was conducted among 262 patients with hemorrhagic stroke at public hospitals in the Harari region of eastern Ethiopia, from September 1, 2019, to August 31, 2024. Factors associated with mortality were identified using the Gompertz hazards regression model.

RESULTS

Of the 262 patients included in the final analysis, 45 (17.18%; 95% CI: 13.05%-22.26%) died. The mortality rate for hemorrhagic stroke was 10.62 cases per 1000 person-months (95% CI: 7.93-14.23). Mortality was significantly associated with patients having kidney disease (AHR: 3.04; 95% CI: 1.44-6.44; p value: 0.004) and poor Glasgow Coma Scale (GCS) scores (AHR: 3.92; 95% CI: 1.58-9.71; p value: 0.003). Septic shock and aspiration pneumonia had exploratory associations with mortality.

CONCLUSION

In-hospital mortality was observed in approximately one in six hemorrhagic stroke patients treated at public hospitals. Risk factors such as kidney disease, aspiration pneumonia, poor GCS, and septic shock increased mortality risk. Hence, special emphasis should be given to early screening for kidney disease and the management of stroke patients with poor a GCS score.