In-hospital case-fatality after intracerebral hemorrhage in southern Iran: a single-center retrospective study.

BACKGROUND

Intracerebral hemorrhage (ICH) is a life-threatening form of stroke associated with high morbidity and in-hospital case-fatality, particularly in low- and middle-income countries. This study aimed to identify clinical factors associated with in-hospital case-fatality among patients with ICH in southern Iran.

METHODS

This retrospective observational study included patients with ICH admitted to Namazi Hospital, a high-volume tertiary referral center in southern Iran, between March 2018 and February 2021. Demographic characteristics, comorbidities, and in-hospital outcomes were extracted from electronic medical records. The primary outcome was in-hospital case-fatality, defined as death during the index hospitalization. Statistical analyses included independent-samples t-tests, chi-square tests, and multivariable logistic regression to identify factors independently associated with in-hospital case-fatality.

RESULTS

A total of 1,796 patients were included in the final analysis. Patients who died during hospitalization were older than survivors (64.6 ± 20.4 vs. 60.3 ± 20.7 years, p < 0.001). Sex, place of residence, and length of hospital stay did not differ significantly between groups in unadjusted analyses. Comorbid conditions, including hypertension, diabetes mellitus, chronic kidney disease, cardiovascular disease, malignancy, and COVID-19 infection, were more frequent among non-survivors (all p < 0.001). In multivariable analysis, diabetes mellitus (OR 3.46, 95% CI 1.40-8.55), hypertension (OR 4.76, 95% CI 3.62-6.27), chronic kidney disease (OR 6.98, 95% CI 3.00-16.27), cardiovascular disease (OR 7.15, 95% CI 4.42-11.57), malignancy (OR 8.83, 95% CI 4.21-18.55), and COVID-19 infection (OR 7.21, 95% CI 3.24-16.08) were independently associated with increased odds of in-hospital case-fatality.

CONCLUSION

In this cohort of patients with ICH, several comorbid conditions were independently associated with in-hospital case-fatality. These findings may support early risk stratification in similar resource-limited settings. Further studies incorporating detailed clinical severity measures are warranted to improve risk prediction and interpretation.