1887
Volume 2026, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Stroke is a major cause of critical illness in resource-limited, conflict-affected regions, yet ICU-based data remain scarce. This study characterizes the epidemiology, temporal trends, and mortality predictors among patients with stroke admitted to the largest tertiary ICU in southern Yemen.

We conducted a retrospective cohort study of adult ICU admissions from October 2019 to September 2021. Stroke cases were identified using codes and classified by subtype (ischemic or hemorrhagic) via neuroimaging and the clinical records. Seasonal trend decomposition (STL) was used to analyze seasonal patterns, and multivariable logistic regression was performed to identify mortality predictors, adjusted for age, sex, and comorbidities.

Among 1244 ICU admissions, 456 (36.7%) were patients with stroke, with a mean monthly admission rate of 19.0 ± 4.2 cases. Ischemic strokes predominated (82.0%; = 374) over hemorrhagic strokes (18.0%; = 82), with the proportion of ischemic strokes increasing from 80.0% to 85.3% ( = 0.08). STL analysis revealed significant seasonal variation, including an October peak (amplitude ±3.8 cases; = 0.003) and an upward trend peaking in March 2021 (+4.2 cases/month; = 0.017). Stroke admissions accounted for 14.6% to 59.4% of monthly ICU occupancy. Overall mortality was 19.1%, higher in hemorrhagic strokes (23.2%) than in ischemic strokes (18.2%; = 0.03). Propensity-matched analysis confirmed increased 30-day mortality in hemorrhagic strokes (26.8% vs. 18.3%; standardized mean difference = 0.21). Multivariable analysis identified hemorrhagic subtype (adjusted OR, 1.82 [95% CI, 1.03–3.21]) and age (adjusted OR, 1.15 per 5-year increase [95% CI, 1.02–1.30]) as independent mortality predictors. Conversely, longer ICU stays were protective (adjusted OR, 0.95 per day [95% CI, 0.91–0.99]).

Stroke accounts for over one-third of ICU admissions in this setting, with hemorrhagic strokes conferring a significantly higher mortality risk. The observed seasonal peak and identified mortality predictors underscore the need for targeted surveillance and management protocols in resource-constrained ICUs.

© 2026 Almogahed, Abdo, Abdullah, Alzanen, Alhakamy, Al-Tahesh, et al, licensee HBKU Press.
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2026-01-22
2026-01-28

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Clinical characteristics and outcomes of ICU-admitted patients with stroke in a resource-limited setting: A retrospective study
Journal of Emergency Medicine, Trauma and Acute Care 2026, 4 (2026); https://doi.org/10.5339/jemtac.2026.4
/content/journals/10.5339/jemtac.2026.4
/content/journals/10.5339/jemtac.2026.4
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Keyword(s): hemorrhagic stroke, hospital mortality, Intensive Care Units, ischemic stroke, Stroke and Yemen

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