This study aimed to investigate the 30-day mortality and long-term outcomes following Spontaneous intracerebral haemorrhage (SICH) in a Tunisian population.

SICH is the second most common type of stroke (15%), with potentially devastating mortality and functional outcome.

We conducted a retrospective study at the department of Neurology at Habib Bourguiba hospital between January 2010 and December 2016. We evaluate possible predictors of 30-day mortality considering clinical and para-clinical parameters. We also applied modified Rankin scale (mRS) to evaluate functional outcome at 12 months. Poor functional outcome was defined as mRS≥3. The rate of recurrent SICH was also determined.

We identified 332 patients with SICH. The mean age was 68.4±13.3 years (18-93 years) and patients were predominantly male (62%). The 30-day mortality was 17.2%. Predictors of mortality were Glasgow coma scale (GCS) ≤12 (P=0.009), systolic blood pressure (SBP) (P=0.003), ICH volume ≥30cc (P=0.02), intraventricular hemorrhage (P<0.001), mass effect (P<0.001) and C reactive protein (CRP) (P=0.007). In multivariate analysis, only SBP≥160 mm Hg (Odds ratio (OR) =2.9, 95% confidence interval (CI) =1.1-7.8, P =0.03) and CRP≥15mg/L (OR =2.8, 95% CI =1.1-7, P= 0.02) were significant predictors for the 30-day mortality. At 12 months, 50% of patients who survived the first 30 days had a persistently poor functional status. Hypertension (P=0.02), infratentorial hematoma location (P=0.04) and mass effect (P=0.01) were associated with poor functional outcome at 1 year. After a mean follow-up of 20.9±14.8 months (6-45 months), 2.1% of patients had recurrent ICH.