Etiology, 3-Month Functional Outcome and Recurrent Events in Non-Traumatic Intracerebral Hemorrhage

Area of Science:

• Neurology
• Stroke Medicine
• Epidemiology

Background:

• Non-traumatic intracerebral hemorrhage (ICH) encompasses diverse etiologies with limited outcome data.
• Understanding the prevalence and impact of various ICH causes is crucial for clinical management.

Purpose of the Study:

• To determine the prevalence of specific ICH etiologies.
• To analyze the association between ICH etiology and patient outcomes, including functional independence and mortality.

Main Methods:

• Prospective enrollment of consecutive ICH patients in the Swiss Stroke Registry (2014-2019).
• Assessment of pre-specified ICH etiologies and their correlation with 3-month outcomes.
• Statistical analysis using adjusted odds ratios (aOR) and confidence intervals (CI).

Main Results:

• Hypertension was the leading etiology (46.7%), followed by unknown (21.4%) and antithrombotic therapy (8.6%).
• ICH due to hypertension was associated with better functional independence (aOR 1.33) and lower mortality (aOR 0.64).
• Antithrombotic therapy-related ICH showed higher mortality (aOR 1.62), while cerebral amyloid angiopathy (CAA) increased recurrent ICH risk (aOR 3.38).

Conclusions:

• Hypertension is the primary cause of ICH, but other etiologies are significant contributors.
• Approximately one-third of ICH patients achieve functional independence at 3 months.
• Cerebrovascular event risk post-ICH varies by etiology, with ischemic stroke being more common than recurrent ICH, except in CAA cases.