Gams Massi Daniel, Pazeu Mikael Doufiene, Motah Mathieu, Magnerou Annick Melanie, Kenmegne Caroline, Mbahé Salomon, Mapoure Njankouo Yacouba
Neurology unit, Douala General Hospital, Douala, Cameroon.
Faculty of Health Sciences, University of Buea.
eNeurologicalSci. 2024 Jul 20;36:100518. doi: 10.1016/j.ensci.2024.100518. eCollection 2024 Sep.
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.
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).
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, = 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, < 0.001), and hospital length ≤ 7 days (RR: 13.5, 95%CI:4.28-42.56, p < 0.001).
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.
自发性蛛网膜下腔出血（sSAH）是一种具有高发病率和死亡率的医疗外科急症。本研究的目的是描述喀麦隆sSAH的临床特征和结局。
我们回顾了2011年1月至2020年12月在杜阿拉总医院因sSAH入院的年龄≥15岁患者的病历。sSAH的诊断通过神经影像学（CT扫描或MRI）得以证实。临床和放射学严重程度分别通过WFNS评分和改良Fisher评分进行评估。使用交叉表（相对危险度和95%可信区间）确定与院内死亡率相关的因素。
在急诊记录中回顾的111例sSAH病例中，我们纳入了70例患者。平均年龄为55.6±13.6岁。女性占主导（57.1%）。意识改变是主要临床特征（55.7%）。54.3%的患者WFNS评分为4 - 5级。75.7%的病例改良Fisher评分为3 - 4级。颅内动脉瘤破裂是最常见的病因（46.2%）。血管内治疗和/或手术治疗不可用。院内死亡率为40%，与死亡相关的因素有意识改变（相对危险度：4.3，95%可信区间：1.52 - 12.33，P = 0.004）、昏迷（相对危险度：23.9，95%可信区间：2.85 - 200.62，P = 0.004）、WFNS 5级（相对危险度：18.2，95%可信区间：3.7 - 92.3，P < 0.001）以及住院时间≤7天（相对危险度：13.5，95%可信区间：4.28 - 42.56，P < 0.001）。
在我们的研究环境中，sSAH的死亡率和致残率仍然很高。需要对患者进行前瞻性随访的进一步研究来确定这些患者的长期结局。
