We hypothesized that low serum LDL levels may have association with intracerebral hemorrhage (ICH) severity at admission and worse outcomes.

The relationship between serum LDL level and ICH is inconclusive. Several studies have noted that low LDL is a risk factor for ICH, however very few studies have defined the link between LDL and ICH severity.

This retrospective study reviewed data obtained from SIREN - the largest multicenter stroke study in Africa. We categorized patients based on their baseline levels of LDL measured at admission, into 4 groups: <70, 70–100, 100-125, >125 mg/dL of LDL. We evaluated initial stroke severity, using the GCS, ICH Score, NIHSS, unfavorable outcomes using mRS.

A total of 1162 patients with ICH (mean age 54.42±13.63 years; 62.5% men) were studied. Nearly all subjects 1125 (96.8%) had hypertension. 766 (65.9%) had fatal outcomes with mean GCS, NIHSS, ICH Score and MRS of 11.12±3.90, 16.84±11.69, 1.74±1.39 and 4.11±1.11 respectively.

Patients with LDL <70 mg/dl were younger (mean age: 52.43±13.06) than those with LDL 70-100, 100-125, >125 who had mean age±SD 53.78±13.73, 56.74±13.26, 53.59±13.00 respectively (P:0.011).

Patients with LDL <70 mg/dL presented with more severe stroke, with a mean GCS±SD of 9.46±3.77 when compared with patients with LDL of 70-100, 100-125, >125 who had a mean GCS 11.42±3.75, 10.11±4.30 and 11.79±3.73 respectively (P-value: 0.007). In the correlation analysis, there was a positive correlation between LDL levels and the GCS (P value: 0.014) and a negative correlation between LDL and the ICH score as well as the NIHSS score at baseline, although not statistically significant.

Mortality of ICH remains high in Africa. LDL<125mg/dl is more common in African subjects with ICH and those with LDL <70mg/dl happened to be much younger.. LDL level < 70 mg/dL was associated with worse Glasgow Coma Score at presentation