Intracerebral Hemorrhages Related to Clinical Conditions and Associated Outcomes Among Saudi and Non-Saudi Patients in a University Hospital: A Retrospective Study.

Objective

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke. The objective of this study was to identify differences between Saudi and non-Saudi patients regarding demographics, clinical conditions, and associated ICH outcomes.

Methods

This retrospective study included patients with ICH (ICD-10 code I61) admitted to a university hospital in Saudi Arabia from April 2014 to April 2019. ICH prevalence patterns were divided into 4 age groups: aged < 60, 60-69, 70-79, and ≥ 80 years. Patient data were collected from the hospital stroke registry. Several outcomes were investigated including death, modified Rankin Scale (mRS) score, external ventricular drain (EVD), and hemicraniectomy. The influence of various demographic and risk factors was studied for each outcome using several analytic techniques.

Results

Of 148 patients, 53% were Saudi and 47% were non-Saudi. Death was reported in 28% of patients and was influenced by many factors including impaired renal function test (> 1.2 mg/dL in females and > 1.4 mg/dL in males) and hematoma size expansion. An unfavorable mRS score after ICH was influenced by impaired renal function test, Glasgow Coma Scale score, and smoking history. EVD insertion was influenced by intraventricular extension of hematoma and being non-Saudi. Hemicraniectomy procedures were associated with impaired renal function test.

Conclusion

Non-Saudi ICH survivors had significant intraventricular extension of hematoma and required more neurosurgical interventions such as EVD procedures compared to Saudi patients. Both groups had associated comorbidities that may influence the incidence of ICH. Appropriate medical care to prevent stroke complications, especially for the older male population, as a strategy for secondary prevention of such neurologic sequelae is recommended.