Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa

Background: Spontaneous subarachnoid hemorrhage (sSAH) is a medicosurgical emergency with high morbidity and mortality. The aimed of this study was to describe the clinical features and outcome of sSAH in Cameroon. Methods: We reviewed medical records of patients aged ≥15 years old, admitted for sSA...

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Main Authors: Daniel Gams Massi, Mikael Doufiene Pazeu, Mathieu Motah, Annick Melanie Magnerou, Caroline Kenmegne, Salomon Mbahé, Njankouo Yacouba Mapoure
Format: Article
Language:English
Published: Elsevier 2024-09-01
Series:eNeurologicalSci
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Online Access:http://www.sciencedirect.com/science/article/pii/S240565022400025X
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author Daniel Gams Massi
Mikael Doufiene Pazeu
Mathieu Motah
Annick Melanie Magnerou
Caroline Kenmegne
Salomon Mbahé
Njankouo Yacouba Mapoure
author_facet Daniel Gams Massi
Mikael Doufiene Pazeu
Mathieu Motah
Annick Melanie Magnerou
Caroline Kenmegne
Salomon Mbahé
Njankouo Yacouba Mapoure
author_sort Daniel Gams Massi
collection DOAJ
description Background: Spontaneous subarachnoid hemorrhage (sSAH) is a medicosurgical emergency with high morbidity and mortality. The aimed of this study was to describe the clinical features and outcome of sSAH in Cameroon. Methods: We reviewed medical records of patients aged ≥15 years old, admitted for sSAH from Januray 2011 to December 2020 in the Douala General Hospital. The diagnosis of sSAH was confirmed by neuroimaging (CT scan or MRI). Clinical and radiological severities were assessed by the WFNS score and the modified Fisher score respectively. Factors associated to in-hospital mortality was identified using cross-table (RR and 95%CI). Results: Among the 111 cases of sSAH reviewed in emergencies records, we included 70 patients. The mean age was of 55.6 ± 13.6 years. Female were predominant (57.1%). Altered consciousness was the main clinical feature (55.7%). The WFNS score was grade 4–5 in 54.3% of patients. And 75.7% of cases presented a modified Fisher score of 3–4. Ruptured of intracranial aneurysm was the most common etiology (46.2%). Endovascular treatment and/or surgical treatment were not avaible. Hospital-based mortality was 40% and factor associated with death were Altered consciousness (RR: 4.3, 95%CI:1.52–12.33, p = 0.004), coma (RR: 23.9, 95%CI:2.85–200.62, p = 0.004), WFNS grade 5 (RR: 18.2, 95%CI:3.7–92.3, p < 0.001), and hospital length ≤ 7 days (RR: 13.5, 95%CI:4.28–42.56, p < 0.001). Conclusion: Mortality and disability of sSAH are still high in our setting. Further studies with prospective follow up of patients are needed to determine the long-term outcome of these patients.
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spelling doaj-art-6ff0475c72ae4a3abdd7c5ab42fcfd5b2025-08-20T03:20:30ZengElseviereNeurologicalSci2405-65022024-09-013610051810.1016/j.ensci.2024.100518Spontaneous subarachnoid hemorrhage in a referral health Centre in Central AfricaDaniel Gams Massi0Mikael Doufiene Pazeu1Mathieu Motah2Annick Melanie Magnerou3Caroline Kenmegne4Salomon Mbahé5Njankouo Yacouba Mapoure6Neurology unit, Douala General Hospital, Douala, Cameroon; Faculty of Health Sciences, University of Buea; Corresponding author at: Neurology unit, Douala General Hospital, PO box: 4856, Douala, Cameroon.Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, CameroonFaculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, CameroonFaculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon; Neurology department, Douala Laquintinie Hospital, Douala, Douala, CameroonNeurology unit, Douala General Hospital, Douala, CameroonNeurology unit, Douala General Hospital, Douala, CameroonNeurology unit, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, CameroonBackground: Spontaneous subarachnoid hemorrhage (sSAH) is a medicosurgical emergency with high morbidity and mortality. The aimed of this study was to describe the clinical features and outcome of sSAH in Cameroon. Methods: We reviewed medical records of patients aged ≥15 years old, admitted for sSAH from Januray 2011 to December 2020 in the Douala General Hospital. The diagnosis of sSAH was confirmed by neuroimaging (CT scan or MRI). Clinical and radiological severities were assessed by the WFNS score and the modified Fisher score respectively. Factors associated to in-hospital mortality was identified using cross-table (RR and 95%CI). Results: Among the 111 cases of sSAH reviewed in emergencies records, we included 70 patients. The mean age was of 55.6 ± 13.6 years. Female were predominant (57.1%). Altered consciousness was the main clinical feature (55.7%). The WFNS score was grade 4–5 in 54.3% of patients. And 75.7% of cases presented a modified Fisher score of 3–4. Ruptured of intracranial aneurysm was the most common etiology (46.2%). Endovascular treatment and/or surgical treatment were not avaible. Hospital-based mortality was 40% and factor associated with death were Altered consciousness (RR: 4.3, 95%CI:1.52–12.33, p = 0.004), coma (RR: 23.9, 95%CI:2.85–200.62, p = 0.004), WFNS grade 5 (RR: 18.2, 95%CI:3.7–92.3, p < 0.001), and hospital length ≤ 7 days (RR: 13.5, 95%CI:4.28–42.56, p < 0.001). Conclusion: Mortality and disability of sSAH are still high in our setting. Further studies with prospective follow up of patients are needed to determine the long-term outcome of these patients.http://www.sciencedirect.com/science/article/pii/S240565022400025XSpontanous sub-arachnoid hemorrhageWFNS scoreModified fisher scoreCameroon
spellingShingle Daniel Gams Massi
Mikael Doufiene Pazeu
Mathieu Motah
Annick Melanie Magnerou
Caroline Kenmegne
Salomon Mbahé
Njankouo Yacouba Mapoure
Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa
eNeurologicalSci
Spontanous sub-arachnoid hemorrhage
WFNS score
Modified fisher score
Cameroon
title Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa
title_full Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa
title_fullStr Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa
title_full_unstemmed Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa
title_short Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa
title_sort spontaneous subarachnoid hemorrhage in a referral health centre in central africa
topic Spontanous sub-arachnoid hemorrhage
WFNS score
Modified fisher score
Cameroon
url http://www.sciencedirect.com/science/article/pii/S240565022400025X
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