Published in PLOS One on 2026-01-07, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Sulemana Baba Abdulai, Julius Kwabena Karikari, Penias Tembo, Theogene Habumugisha, William Tembo, Alhaji Ibrahim Cobbinah, Yeetey Enuameh
Source: PLOS One • DOI 10.1371/journal.pone.0340447
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Stroke is a leading cause of death and disability worldwide. In Ghana, national estimates show a prevalence of 7.9% and an incidence rate of 1.2%, placing a significant burden on the health system. This study aimed to estimate in-hospital survival rates and identify predictors of mortality among stroke patients admitted to Tamale Teaching Hospital (TTH).
A retrospective electronic medical records review was conducted using data from the Lightwave Health Information Management System (LHIMS) and patients’ registry from January 1 2021 to December 31 2023. Kaplan-Meier survival curve was used to determine the survival rate of stroke patients (mean follow-up: 67 days). Cox proportional hazard regression determined the association between risk factors and survival time. Crude and adjusted hazard ratios with 95% confidence intervals were presented. A p-value of 0.05 was considered statistically significant.
A total of 998 stroke patients were included, of which 39.4% died. The overall survival rate was 21% at the end of follow-up (182 days). The survival probability for female stroke patients was lower compared to males. Female sex (AHR = 1.33, 95% CI: 1.07–1.65), Dagomba ethnicity (AHR = 1.31, 95% CI: 1.05–1.62), pneumonia (AHR = 1.59, 95% CI: 1.27–1.97), diabetes mellitus (AHR = 0.62, 95% CI: 0.47–0.82), systolic blood pressure ≥ 130 mmHg (AHR = 1.35, 95% CI: 1.06–1.73), and temperature ≥ 37.5°C (AHR = 1.79, 95% CI: 1.37–2.33) were predictors of mortality.
Female stroke patients experienced higher mortality and lower survival compared to males. The identified mortality predictors underscore the importance of focused interventions to enhance survival outcomes at TTH. Given the retrospective design and possible unmeasured confounders, the lower mortality risk among diabetic patients should be interpreted with caution, and prospective studies are warranted to confirm these associations.
Introduction
Stroke is an acute neurological dysfunction of the brain, spinal cord, or retina caused by focal ischemia (infarction) or haemorrhage, including cases due to cerebral venous thrombosis [1]. It is a multifaceted disease influenced by risk factors such as hypertension, diabetes, and heart failure [2]. Globally, stroke remains a leading cause of death and disability, responsible for significant health burdens, including an annual loss of approximately 1,484 disability-adjusted life years (DALYs) per 100,000 people [3]. Survivors often endure long-term physical, cognitive, and emotional challenges, imposing substantial demands on families, social, and healthcare systems [4].
In sub-Saharan Africa (SSA), the burden of stroke is rapidly increasing due to an epidemiological shift towards non-communicable diseases (NCDs) [5]. Stroke incidence and mortality rates in SSA are alarmingly high, with incidence reaching up to 1,460 cases per 100,000 people, and a three-year fatality rate exceeding 80% [6]. Challenges such as inadequate health infrastructure, limited neurologists, and low awareness of stroke symptoms exacerbate poor outcomes in the region [7]. In Ghana, stroke ranks among the top five causes of death, with concerning trends in rising admissions and a one-month hospital fatality rate of up to 43% [8,9]. Over the past three decades, the country has witnessed a consistent rise in stroke incidence, admissions, and mortality. For instance, stroke-related admissions in Kumasi increased from 5.32 per 1,000 in 1983 to 13.85 per 1,000 in 2010, with one-month fatality rates reaching 41% in the Central Region [9]. Key modifiable risk factors, including high salt intake, physical inactivity, and limited consumption of green leafy vegetables, are prevalent in Ghana [10]. Additionally, younger populations under 40 years are increasingly affected, posing significant socio-economic challenges [11].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Sulemana Baba Abdulai, Julius Kwabena Karikari, Penias Tembo, Theogene Habumugisha, William Tembo, Alhaji Ibrahim Cobbinah, Yeetey Enuameh. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025
- Evidence brief: Predictors of tuberculosis mortality among patients on treatment: A retrospective cohort study at a rural general hospital in Zambia
- Evidence brief: Time to maternal death and its predictors among obstetric ICU patients in a resource-limited setting: A 10-year survival analysis
