TITLE:
Risk Factors for Mortality in the Acute Phase of Hemorrhagic Stroke at Befelatanana University Hospital, Antananarivo, Madagascar
AUTHORS:
Lala Andriamasinavalona Rajaonarison, Volatiana Hélinà Rakotomalala, Rahamefy Odilon Randrianasolo, Nomena Finiavana Rasaholiarison, Alain Djacoba Tehindrazanarivelo
KEYWORDS:
Hemorrhagic Stroke, Risk Factors, Mortality, Madagascar
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.14 No.3,
August
26,
2026
ABSTRACT: Background: Hemorrhagic stroke is characterized by the sudden onset of a neurological deficit of presumed vascular origin, resulting from blood extravasation into the cerebral parenchyma. This study aimed to identify clinical and paraclinical risk factors associated with mortality during the acute phase of hemorrhagic stroke at Befelatanana University Hospital. Methods: We conducted a retrospective case-control study, over a 30-month period. All hospitalized patients diagnosed with hemorrhagic stroke confirmed by neuroimaging were included. Cases were defined as patients who died within the first 7 days of admission due to neurological causes; controls were patients discharged alive from the neurology department. Independent predictors of mortality were subsequently identified using multivariate binary logistic regression. Results: A total of 313 patients were included, with a slight male predominance (50.8%) and a mean age of 55.5 ± 11.3 years. Factors significantly associated with mortality on bivariate analysis included: mean arterial pressure ≥ 130 mmHg (p Conclusions: Identification of these risk factors may improve early management strategies during the acute phase of stroke. Multivariate analysis confirms altered consciousness, cerebral herniation, hydrocephalus, and elevated mean arterial pressure as independent early predictors, which should guide risk stratification and clinical decision-making from admission.