National Incidence of Intracranial Haemorrhage-Related Hospitalisations and Mortality in England 2014-2019

Background: Intracranial haemorrhage (ICrH) is the most frequent cause of bleeding-related death. However, few studies describe the national incidence of ICrH-related acute hospitalisations and mortality. We report the national burden and incidence of hospitalisation and mortality of ICrH and its subtypes. Methods: A population-based review in England between 2014 and 2019 of acute admissions or deaths was undertaken. Admission and mortality data were obtained from electronic databases (traumatic death data were unavailable). ICrH events were identified by the International Classification of Diseases Version 10 codes. ICrH were subclassified by anatomical site and either traumatic or atraumatic cause. Results: In the 6-year study period, there was a total of 468,996 hospitalisations for ICrH, of which 280,003 (59.7%) were atraumatic and 188,993 (40.3%) were traumatic. Then, 50,004 atraumatic ICrH-related deaths were recorded; of these deaths, 43,061 were subclassified by anatomical site. The mean annual incidence rates (per 100,000 person years) were 141.0 for ICrH-related hospitalisations and 15.0 for atraumatic ICrH-related mortality. Males had a 7% higher incidence rate for atraumatic ICrH-related hospitalisations (OR 1.07, 95% CI 1.05-1.09, p < 0.0001). Females had a higher mean annual atraumatic ICrH-related mortality (OR 1.21, 95% CI 1.16-1.26, p < 0.0001). Then, 23.4% (n = 109,770) of all ICrH hospitalisations occurred in patients ≥ 85 years. Conclusion: The majority of ICrH acute hospitalisations (59.7%) were atraumatic. Sex differences were seen in outcome measurements: males had a higher overall incidence of hospitalisation; however, females had a higher incidence of atraumatic ICrH-related mortality.