, Department of Neurological Surgery, Rutgers New Jersey Medical School Newark, New Jersey, United States
Introduction: Intracerebral hemorrhage is the second most common form of stroke but has the highest rates of mortality. In this study, we identify the risk factors and comorbidities associated with increased mortality in patients with intracerebral hemorrhage and the effects it has on inpatient hospital course.
Methods: The 2016 to 2020 National Inpatient Sample (NIS) was used to identify adult inpatients with a primary diagnosis of non-traumatic subarachnoid hemorrhage. Univariate and multivariable analyses adjusting for patient demographics, comorbidity status, and etiology were used to characterize statistical associations with disease-related complications.
Results: A total of 443,590 patients were identified as having intracerebral hemorrhage from 2016 to 2020. Most patients were over the age of 60 (69%) and 52.8% were males. The majority of patients were white (61.4%), followed by black (18%), Hispanic (10.7%), and other (9.9%). Medicare (59%) followed by private insurance (20.6%) and Medicaid (12.3%) were the main primary payers used by patients. Patients with intraventricular intracerebral hemorrhage (Odds Ratio [OR]:2.64, 95% Confidence Interval [CI]:2.59-2.70, p< 0.001), intracerebral hemorrhage in the cerebellum (OR:1.21, CI:1.17-1.25, p< 0.001), intracerebral hemorrhage in the brainstem (OR: 3.37, CI: 3.29-3.50, p< 0.001), intracerebral hemorrhage in multiple locations (OR:2.43, CI:2.26-2.61, p< 0.001), and coagulation deficiencies (OR:1.41, CI:1.38-1.44, p< 0.001) had an increase in mortality. Coagulation disorders and deficiencies were associated with increased length of stay (10.19±0.06 days vs. 8.19±0.02 days, p< 0.001), increased total costs ($163,388.24±1037.49 vs. $114,697.04±284.61, p< 0.001), increased number of procedures (3.29±0.017 vs. 2.18±0.005; p< 0.001), increased number of days from admission to first procedure (1.99±0.022 vs. 1.88±0.009; p< 0.001), and increased mortality (27.1% vs. 20.7%, p< 0.001).
Conclusion : In patients with Intracerebral hemorrhage, coagulation disorders and deficiencies are associated with an increase in mortality, length of stay, total cost, number of procedures in patients, and number of days to first procedure.
