Temporal trends in risk factors and outcome of intracerebral hemorrhage over 18 years at a tertiary care hospital in Karachi, Pakistan

J Stroke Cerebrovasc Dis. 2012 May;21(4):289-92. doi: 10.1016/j.jstrokecerebrovasdis.2010.09.001. Epub 2010 Oct 22.


Background: The purpose of this study was to analyze the baseline characteristics and outcomes of intracerebral hemorrhage (ICH) patients at our center over the last 18 years.

Methods: Patients with ICH (first-time) were identified from medical records using International Classification of Diseases, Ninth Revision codes from 1988 to 2005. Patients were divided into 2 groups, with each group spanning 9 years based on the year of admission: the old group (admitted between 1988 and 1996) and the newer group (admitted between 1997 and 2005).

Results: Out of 920 patients, the number of admissions with ICH increased from <40 per year (average) during 1988 to 1996 to >60 per year (average) during 1997 to 2005. The findings indicate that the percentage of cases in males decreased from 72% to 55% in the newer group as compared to the older group, while female ICH admissions increased from 28% to 45%. Mean age of ICH onset for both men and women decreased about 5 years, but this difference was not statistically significant. Frequency of diabetes (14% v 30%), dyslipidemia (3% v 18%), and the use of antihypertensive medications (29% v 69%) was higher in newer group, while the frequency of lobar hemorrhage was found to be reduced (40% v 20%) in newer group. Lower mortality (22% in the newer group v 32% in the older group) was noted. A decreased length of hospital stay for the newer group was recorded, but this difference was not found to be statistically significant.

Conclusion: The mean age of ICH onset for both men and women has decreased about 5 years in the newer group. Men and women were equally affected in recent years as compared to male predominance in the older group.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebral Hemorrhage / mortality*
  • Cerebral Hemorrhage / therapy*
  • Child
  • Comorbidity / trends
  • Female
  • Hospitalization* / trends
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Pakistan / epidemiology
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Assessment / trends
  • Young Adult