Abstract Details

Title Baseline Characteristics and Readmissions Analysis in Younger and Older Adults with Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S15 - Intracerebral Hemorrhage and SAH (2:06 PM-2:17 PM)

Poster/Presentation
Number 007

Background Data regarding characteristics and outcomes of primary ICH in the young are lacking due to its rarity, making comparisons between younger and older cohorts difficult to perform. Administrative databases enable analysis of such rare events utilizing nationally representative data.

Objective To compare baseline characteristics and readmission rates and reasons among “younger” (18-45 years) and “older” (>45 years) individuals admitted for intracerebral hemorrhage (ICH).

Design/Methods A retrospective cohort analysis was performed using the Nationwide Readmissions Database 2013. Validated ICD-9CM codes identified index ICH admissions, comorbidities, demographics, behavioral risk factors, procedures, and the Elixhauser comorbidity index. We compared “younger” and “older” index ICH admissions by weighted 30-day all-cause readmission rates; primary diagnosis code for 30-day readmissions; most common comorbidities during the index hospitalization; and Kaplan-Meier cumulative risk of readmission up to 1 year.

Results

There were 1929 “younger” and 25810 “older” index ICH admissions. Though “older” admissions had higher comorbidity scores and mortality, both groups had similar total comorbidities (12 vs. 14). “Younger” admissions exhibited longer length of stay (14 vs. 10 days) with more procedures performed (3.3 vs. 2.3). Vascular anomalies (aneurysm 7.2% vs. 4.6%; arteriovenous malformation 5.9% vs. 0.8%) and behavioral risk factors (smoking 26.5% vs. 23.0%; alcohol abuse 6.7% vs. 4.6%; substance use 13.5% vs. 2.9%) were more prevalent in “younger” admissions while “older” patients had more cardiovascular comorbidities. All-cause 30-day readmission rates (13.1% vs. 13.0%) and 1-year cumulative risk of readmission (log-rank p-value 0.7209) were similar. Readmissions in the “younger” cohort were primarily for neurological conditions; those in the “older” cohort were for systemic conditions.

Conclusions Despite younger age, adults <45 years with ICH had similar total comorbidities as older adults, but more procedures, longer hospital stay, and more behavioral risk factors. Readmission rates were similar though the reasons differed; younger patients’ were more for neurologic reasons than for other systemic causes.

Authors/Disclosures
Brian Kim, MD (Elmhurst Hospital) PRESENTER	No disclosure on file
Christeena Kurian, MD (Westchester Medical Center)	No disclosure on file
Laura Stein, MD (Mount Sinai School of Medicine)	The institution of Dr. Stein has received research support from American Heart Association.
Stanley Tuhrim, MD (Mount Sinai Medical Center)	No disclosure on file
Mandip S. Dhamoon, MD, MPH	Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Faegre Baker Daniels LLP. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Wellstar Health System Inc. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Fabiani Cohen & Hall, LLP. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Kramer, Dillof, Livingston & Moore. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Robins Kaplan. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Parker Waichman LLP. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Heidell, Pittoni, Murphy & Bach, LLP.

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