Treatment outcomes and associated factors of Aneurysmal Subarachnoid Hemorrhage patients treated at Ethiopia's first comprehensive stroke center

Abstract

Introduction : Aneurysmal subarachnoid hemorrhage (aSAH) is a critical cerebrovascular condition characterized by bleeding into the subarachnoid space due to ruptured cerebral aneurysms. Many low- and middle-income nations, including Ethiopia, despite worldwide advancements face difficulties in managing this illnes due to resource limitation. Objective: To assess treatment outcomes and associated factors among aSAH patients treated at Ethiopia’s first comprehensive stroke center in a resource-limited setting. Method: A retrospective cohort study was conducted using patient records from Axon Stroke and Spine Center between October 2022 and February 2024. Data were collected via structured questionnaires and analyzed with STATA 14 using descriptive statistics and multivariable logistic regression. The primary outcome was the Modified Rankin Scale (mRS) at 1 month post-discharge. Results: Among 198 patients analyzed, 65.66% had favorable outcomes (95% CI: 58.98%–72.32%). Favorable outcomes were associated with absence of hypertension (AOR = 2.90), anemia (AOR = 3.21), cerebral edema (AOR = 12.94), absence of hospital-acquired infection (AOR = 3.75), and Fisher Grade 1 on admission (AOR = 6.80). Conclusion and recommendation: Absence of comorbidities like hypertension, anemia, and infections improve aSAH outcomes. Public education, efficient referral, hypertension control, anemia screening, cerebral edema monitoring, and infection prevention should be prioritized to enhance care and survival.