Abstract Details

Title Unraveling the Risk factors for Spontaneous Intracerebral Hemorrhage and its Severity among West Africans

Topic General Neurology

Presentation(s) P9 - Poster Session 9 (12:00 PM-1:00 PM)

Poster/Presentation
Number 6-005

Objective To characterize risk factors for spontaneous intracerebral hemorrhage (SICH) occurrence and severity among West Africans.

Background Spontaneous intracerebral hemorrhage has remained a serious disease despite recent improvements in medical treatment Africans are at a higher risk for intracerebral hemorrhage (ICH). Despite the aforementioned, little is known about the factors associated with spontaneous ICH.

Design/Methods The Stroke Investigative Research and �鶹��ýӳ��al Network (SIREN) study is a multicenter case-control study involving 15 sites in Ghana and Nigeria. Cases were adults ≥18 years old with Computed Tomography scan confirmed SICH with age, sex, and ethnicity-matched stroke-free community controls. Standard instruments were used to assess vascular, lifestyle and psychosocial factors. The factors associated with SICH and its severity were assessed using conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% CIs for factors.

Results Of 2,944 stroke cases, 854 were ICH. Mean age of ICH cases was 54.7±13.9 years, with a male preponderance (63.1%) and 77.3% were non-lobar. Etiologic subtypes of SICH included hypertension (80.9%), structural vascular anomalies (4.0%), cerebral amyloid angiopathy (0.7%), systemic illnesses (0.5%), medication-related (0.4%) and undetermined (13.7%). Eight factors independently associated with SICH occurrence by decreasing order of PAR with their adjusted OR (95% CI) were hypertension, 66.63(20.78-213.72); dyslipidemia, 2.95(1.84-4.74); meat consumption, 1.55(1.01-2.38); family history of CVD, 2.22(1.41-3.50); non-consumption of green vegetables, 3.61(2.07-6.31); diabetes mellitus, 2.11(1.29-3.46); stress, 1.68(1.03-2.77); and current tobacco use, 14.27(2.09-97.47). Factors associated with severe SICH using an NIHSS score>15 with aOR (95%CI) were non-consumption of green leafy vegetables; 2.03(1.43-2.88), systolic BP for each mmHg rise; 1.01 (1.00-1.01), presence of midline shift; 1.54(1.11-2.13), lobar ICH; 1.72(1.16-2.55), supratentorial bleeds; 2.17(1.06-4.46).

Conclusions Population-level control of the dominant factors will significantly mitigate the burden of SICH in West Africa.

Authors/Disclosures
Mayowa Owolabi, MD, F�鶹��ýӳ�� (Neurology Unit, Dept of Med, UCH) PRESENTER	Dr. Owolabi has nothing to disclose.
Fred Sarfo	Fred Sarfo has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Kolawole W. Wahab, MD, F�鶹��ýӳ�� (University of Ilorin Teaching Hospital)	Dr. Wahab has nothing to disclose.
	No disclosure on file
Rufus O. Akinyemi, MD (Institute for Advanced Medical Research and Training)	Dr. Akinyemi has nothing to disclose.
Morenikeji Komolafe, MD (Obafemi Awolowo University)	Dr. Komolafe has nothing to disclose.
	No disclosure on file
Lukman F. Owolabi, PhD, MSc, FWAPC, FMCP (Bayero University)	Dr. Owolabi has nothing to disclose.
Daniel T. Lackland, PhD (Medical University of South Carolina)	An immediate family member of Prof. Lackland has received personal compensation for serving as an employee of Sound Pharmacetical. Prof. Lackland has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley Publishing. Prof. Lackland has received publishing royalties from a publication relating to health care.
	No disclosure on file
Hemant Tiwari	No disclosure on file
	No disclosure on file
Bruce I. Ovbiagele, MD, MSc, F�鶹��ýӳ�� (San Francisco VA)	Dr. Ovbiagele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Stroke Association. Dr. Ovbiagele has received research support from National Institutes of Health. Dr. Ovbiagele has a non-compensated relationship as a President with Society for Equity Neuroscience that is relevant to �鶹��ýӳ�� interests or activities. Dr. Ovbiagele has a non-compensated relationship as a Board Member with World Stroke Organization that is relevant to �鶹��ýӳ�� interests or activities.