Neurological inpatient care in Ethiopia: analyzing admission trends, outcomes, and predictors of mortality

Neurological diseases (NDs) are a major cause of morbidity and mortality globally, with a disproportionate burden in sub-Saharan Africa, including Ethiopia. However, data on admission patterns, clinical outcomes, and predictors of in-hospital mortality among neurological inpatients remain limited. To assess admission patterns, in-hospital outcomes, and factors associated with mortality among patients admitted to neurology inpatient services at a tertiary hospital in Ethiopia. A hospital-based retrospective cohort study was conducted by reviewing medical records of adult neurology inpatients admitted to Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia, from January 1 to December 31, 2021. A total of 257 patients were included, with a mean age of 47.3 ± 18.4 years. Cerebrovascular diseases accounted for 144 (56.0%) admissions, followed by infections of the nervous system 68 (26.5%). The median length of hospital stay was 9 (IQR: 6–15) days. In-hospital mortality was 15.2% (39/257). The most common causes of death were ischemic stroke 17 (43.6%) and central nervous system infections 15 (38.5%). On multivariable logistic regression, admission Glasgow Coma Scale ≤ 12, HIV infection, pneumonia, sepsis, and multiple hospital-acquired complications were independently associated with in-hospital mortality. Neurological admissions at this tertiary center were predominantly due to cerebrovascular diseases and infections. In-hospital mortality remains considerable and is associated with disease severity and hospital-acquired complications. Strengthening early recognition, infection prevention, and supportive care may improve outcomes.