Risk factors for 30-day in-hospital mortality for in-patient with stroke in sub-Saharan Africa: protocol for a systematic review and meta-analysis.

INTRODUCTION: While individual studies have reported on in-hospital stroke mortality rates in sub-Saharan Africa (SSA), the estimates are highly variable and inconclusive, buttressing the need for precise and reliable estimations. To overcome these inconsistencies, a well-structured systematic review and meta-analytical models are necessary. However, to the best of our knowledge, there is no published systematic review and meta-analysis on risk factors for 30-day mortality for in-hospital patients with stroke in SSA. METHOD AND ANALYSIS: We will include all retrospective and prospective facility-based observational studies reporting on the incidence and/or risk factors for in-hospital stroke mortality in SSA. Electronic databases such as PubMed, Google scholar and Africa Journal Online (AJOL) will be searched for potentially relevant studies on in-hospital stroke mortality and risk factors in SSA. The search will be limited to studies conducted from January 1990 to December 2020. Two independent authors will screen titles and abstract to find studies that meet the prespecified eligibility criteria for inclusion in the review. The incidence of 30-day in hospital stroke mortality will be pooled. Meta-regression will be used to assess the factors associated with in-hospital stroke mortality in SSA. If possible, subgroup analysis will be performed based on subregion, publication year and study design, and quality score to determine possible source of heterogeneity. If possible, a sensitivity analysis will be performed to determine the robustness of the estimates obtained from the meta-analysis. ETHICS AND DISSEMINATION: Ethical approval is not required as this is a secondary research and will use reported data in scientific literature. A full manuscript will be submitted to a reputable peer-review journal for publication. PROSPERO REGISTRATION NUMBER: CRD42021227367. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.