Abstract:
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening cerebrovascular emergency associated with high morbidity and mortality, particularly in low- and middle-income countries. Despite global advances in neurovascular care, outcomes remain variable due to differences in infrastructure, timely intervention, and comorbid conditions. In Ethiopia, data on aSAH outcomes remain limited.
Objective: To assess treatment outcomes and identify associated factors among patients with aneurysmal subarachnoid hemorrhage treated at Ethiopia’s first comprehensive stroke center.
Methods: A retrospective cohort study was conducted at Axon Stroke and Spine Center, Addis Ababa, Ethiopia, including patients diagnosed with aSAH between October 2022 and February 2025. Data were extracted from electronic medical records using a structured tool and analyzed using STATA version 14. Descriptive statistics summarized patient characteristics. Bivariate and multivariable logistic regression analyses were used to identify factors associated with favorable outcomes. The primary outcome was functional status measured using the modified Rankin Scale (mRS) at one month post-discharge. A favorable outcome was defined as mRS ≤3.
Results: A total of 134 patients were included. The majority were female with a mean age of 47.76 years (±15.38). Most patients presented with severe headache and had Hunt-Hess grade II at admission. Hypertension was the most common comorbidity. Primary coiling was the most frequently used treatment modality in above half patients. The overall proportion of favorable outcomes was noticed in more than half of the patients. On multivariable analysis, absence of hypertension, absence of anemia, absence of cerebral edema, absence of hospital-acquired infection, and Fisher grade I at admission were significantly associated with favorable outcomes.
Conclusion: More than half of patients achieved favorable outcomes. Clinical severity at presentation and inhospital complications significantly influenced prognosis. Strengthening early detection, controlling hypertension, preventing infections, and optimizing acute neurocritical care may improve outcomes in aSAH patients in resource-limited settings.
Biography:
Dr. Michael Yirgalem Teka is a medical doctor and clinical researcher at Axon Stroke and Spine Center in Addis Ababa, Ethiopia. He is involved in stroke care, neurocritical management, and clinical research focusing on cerebrovascular diseases in lowresource settings. His work emphasizes improving outcomes in aneurysmal subarachnoid hemorrhage and strengthening stroke systems of care in Ethiopia. He has contributed to clinical coordination, teaching, and research in neurology-related fields and continues to engage in evidencebased improvement of acute stroke management.
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