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A Population-Based Study of Intracerebral Hemorrhage Survivors' Outcomes
Julius Griauzde1, Lynda D Lisabeth2, Chengwei Li2
1Department of Radiology, Michigan Medicine, Ann Arbor, Michigan.
Insights
Intracerebral hemorrhage survivors experienced worse cognitive outcomes in Mexican Americans compared to non-Hispanic whites. Neurologic, functional, and quality of life outcomes did not differ by sex or ethnicity.
Area of Science:
- Neurology
- Public Health
- Health Outcomes Research
Background:
- Intracerebral hemorrhage (ICH) is a significant cause of mortality and morbidity.
- Understanding long-term outcomes by demographic factors is crucial for targeted interventions.
- Previous research has not fully elucidated sex and ethnic disparities in ICH recovery.
Purpose of the Study:
- To evaluate 3-month neurologic, functional, cognitive, and quality of life (QOL) outcomes after intracerebral hemorrhage (ICH).
- To specifically assess differences in these outcomes based on sex and ethnicity within a population-based cohort.
Main Methods:
- A population-based study identified spontaneous ICH patients from November 2008 to December 2013.
- Neurologic, functional, cognitive, and QOL outcomes were assessed at 3 months using validated scales.
- Ethnic and sex differences were analyzed using Tobit regression, adjusting for relevant covariates.
Main Results:
- Cognitive outcomes were significantly worse in Mexican Americans (MA) compared to non-Hispanic whites (NHW).
- MA participants scored 13.3 points lower on the Modified Mini-Mental State Examination (3MSE) compared to NHW.
- No significant differences were observed in neurologic, functional, or QOL outcomes based on sex or ethnicity.
Conclusions:
- Mexican Americans exhibit poorer cognitive recovery following intracerebral hemorrhage compared to non-Hispanic whites.
- Sex and ethnicity do not appear to influence neurologic, functional, or quality of life outcomes in ICH survivors.
- Further research is needed to understand and address ethnic disparities in cognitive outcomes post-ICH.
Background:
We evaluated 3-month neurologic, functional, cognitive, and quality of life (QOL) outcomes in intracerebral hemorrhage (ICH) overall, and by sex and ethnicity in a population-based study.
Methods:
Spontaneous ICH patients were identified from the Brain Attack Surveillance in Corpus Christi project (November 2008 to December 2013). Outcomes included neurologic (National Institutes of Health Stroke Scale: range 0-42), functional (activities of daily living/instrumental activities of daily living score: range 1-4, higher worse), cognitive (Modified Mini-Mental State Examination [3MSE]: range 0-100), and QOL (short-form stroke-specific QOL scale: range 0-5, higher better). Ethnic and sex differences were assessed with Tobit regression adjusted for age, sex, or ethnicity, and presenting Glasgow coma scale.
Results:
A total of 245 patients completed baseline interviews, with 103 (42%) dying prior to follow-up, leaving 142 eligible for outcome assessment. Three-month follow-up was completed in 100 (neurologic), 107 (functional), 79 (cognitive), and 83 (QOL) participants. Median age was 66 years (interquartile range 58.0-77.0). Cognitive outcomes were worse in Mexican Americans (MA) compared to non-Hispanic whites (NHW) after multivariable adjustment (MA scoring 13.3 3MSE points lower than NHW [95% confidence interval: 5.8, 20.7; P = .0005]). There was no difference by sex or ethnicity in neurological, functional, or QOL outcomes, and no sex differences in cognitive outcomes.
Conclusions:
In this population-based study, worse cognitive outcomes were found in MAs compared with NHW. There were no differences between neurologic, functional, and QOL outcomes in ICH survivors based on sex or ethnicity.