Factors Associated with Inpatient Mortality after Intracerebral Hemorrhage: Updated Information from the United States Nationwide Inpatient Sample
Document Type
Article
Publication Date
3-1-2020
Abstract
Background: To use a nationwide database of hospital admissions to assess for trends in inpatient mortality from acute spontaneous intracerebral hemorrhage as well as associated potentially contributing factors. Methods: Adults with intracerebral hemorrhage in the US National Inpatient Sample database from 2012 to 2015 were included in this study. We assessed for mortality rate as well as potential impact of various comorbidities and demographic factors such as ethnicity and median house hold income on inpatient mortality rate. Results: A total of 47,700 patients were identified with a mean age of 68 years. The overall mortality rate was 24%. Hypertension was the commonest comorbidity (84%) followed by diabetes mellitus (28%). Positive associated factors for mortality rate were coagulopathy (OR 1.28, 95% CI 1.19-1.38, P <. 001), female gender (OR 1.12, 95% CI 1.08-1.17, P <. 001), and congestive heart failure (OR 1.16, 95% CI 1.08-1.24, P <. 001). Age greater than 75 was also associated with higher mortality (P <. 001). Factors associated with reduced mortality were hypertension (OR. 76, 95% CI. 72-0.81, P <. 001), hypothyroidism (OR. 87, 95% CI. 81-.93, P <. 001) and obesity (OR. 64, 95% CI. 59-.69, P <. 001). Conclusions: The inpatient mortality of 24% represents a decline when compared to previous years. Attention to the associated factors with mortality, that we report, could have some potential impact on management. Of interest, we found support for obesity paradox in which obesity may have an actual salutary effect on vascular disease outcome. Our observed paradoxical effects, not only for obesity, but also hypertension and hypothyroidism, warrant further study.
Publication Source (Journal or Book title)
Journal of Stroke and Cerebrovascular Diseases
Recommended Citation
Javalkar, V., Kuybu, O., Davis, D., & Kelley, R. (2020). Factors Associated with Inpatient Mortality after Intracerebral Hemorrhage: Updated Information from the United States Nationwide Inpatient Sample. Journal of Stroke and Cerebrovascular Diseases, 29 (3) https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104583