Comparative study of inpatients transported from rural areas and urban due to intracerebral haemorrhage

Abstract

Background: Non-traumatic intracerebral haemorrhage (ICH) is a neurological emergency, because it carries a burden of mortality and long-term disability worldwide. Aim: To compare urban and rural differences in hospitalisation due to ICH. Material and Methods: An analytical study was conducted among ICH cases admitted to the Third State Central Hospital between 2022 and 2024, and statistical analysis was performed using SPSS 27.0. Results: The study included 373 cases of acute ICH diagnosed by computed tomography between 2022 and 2024 at the Third State Central Hospital, of which n=313 were from Ulaanbaatar city, and n=60 were transported from the rural area. Compared to the urban group, the rural group had fewer males, but a history of arterial hypertension prevailed (98.3% vs 90.1%, p=0.041), and lower blood pressure at the time of hospitalisation (systolic pressure 159.7±34.7 mm Hg vs 179.0±32.9 mm Hg, p<0.001; diastolic pressure 99.7±21.4 mm Hg vs 106.5±21.8 mm Hg, p=0.026). Cases in the rural group had a longer hospital stay from the onset of clinical symptoms than those in the urban group (12.1±17.9 hours vs 4.2±4.3 hours, p=0.001). Multivariate regression analysis showed that lower hematoma volume (adjusted odds ratio [aOR] 0.92, p=0.047) and lower NIHSS score at hospital admission (aOR 0.67, p<0.001) were associated with better outcomes. However, multivariate regression analysis showed that hospital admission NIHSS score was the only risk factor directly associated with mortality after 3 months (aOR 1.14, p=0.005). Conclusion: Our study found that indicators for patients transported from rural areas with IHC were no different from those for patients in urban areas. On the contrary, mortality was independent of length of hospital stay and residency.