Long-Term Mortality of Hemorrhagic Stroke Survivors in Bobo-Dioulasso, Burkina Faso: A Retrospective Hospital-Based Cohort Study

Introduction. Long-term survival of hemorrhagic strokes remains poorly evaluated in our context. They represent the most severe type of stroke, accounting for 10 to 20% of all stroke cases. These rates are elevated in sub-Saharan Africa, potentially accounting for as much as 35% of all strokes. This study’s purpose was to analyze the long-term mortality of stroke survivors at the Souro Sanou University Hospital in Bobo-Dioulasso. Methods. This was a retrospective cohort of patients hospitalized from January 1, 2017 to December 31, 2019, discharged alive from the neurology department after haemorrhagic stroke. Data were analyzed using STATA 17.0 software. The 4-year survival probability was estimated. Predictors of mortality were identified using Cox regression. Results. A total of 57 patients were involved in this study. The mean age was 58.4 years (±12.4). The sex ratio was 1.19. Hypertension was the main cardiovascular risk factor (71.9%). Four patients had a history of heart disease. The level of consciousness was normal in 50 patients. The average length of hospital stay was 11.3 days. Cumulative post-hospital mortality was 21.1% at 4 years. Predictors of mortality were Glasgow coma scale>9 (p=0.001; HR = 0.09; CI 95%: 0.02-0.40) and presence of heart disease (p=0.015; HR = 5.87; CI 95%: 1.42-24.29). Conclusion. The long-term mortality associated with haemorrhagic stroke is high. Targeted interventions such as specialist hypertension clinics, cardiological follow-up and structured outpatient programmes could improve this long-term mortality considerably.