Abstract
Background
Identification and modification of risk factors are essential for preventing intracerebral
hemorrhage (ICH). Prior hospital admissions provide opportunities to intervene. We
reported hospital admissions prior to primary ICH and investigated factors associated
with survival.
Methods
Cohort design using patient-level data from the Australian Stroke Clinical Registry
(2009-2013) linked with hospital administrative datasets from four states (VIC, NSW,
WA, QLD). Prior hospital admission is divided into within 90 days and more than 90
days prior to the index ICH event. The International Classification of Diseases and
Related Health Problems, Tenth Revision, Australian Modification codes were used to
define principal diagnoses of previous admissions/presentations and comorbidities.
Factors associated with survival after ICH were investigated using Cox proportional
hazards regression.
Results
Among 15,482 admissions for stroke, 2,098 (14%) had an ICH (median age 76 years, 52%
male), 1,732 patients (83%) had a prior hospital admission, including 440 patients
(21%) within 90 days of their index ICH admission. Patients with prior admission were
older, had more comorbidities, and greater hospital frailty risk score than those
without prior admission. Diseases of the circulatory system (14%) were the most common
principal diagnoses for hospital admissions prior to ICH. Of the comorbidities associated
with survival, neoplasms conferred the greatest hazard of death at 180 days after
ICH (adjusted hazard ratio 1.42, 95% confidence interval 1.15 – 1.76, p = 0.001).
Conclusion
Hospital presentations in the 90 days prior to ICH are common. Future research should
be focussed on identifying opportunities for preventing ICH.
Key words
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Article info
Publication history
Accepted:
June 3,
2020
Received in revised form:
May 24,
2020
Received:
March 25,
2020
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105026
Copyright
© 2020 Elsevier Inc. All rights reserved.
