Objective:

To evaluate racial and ethnic differences in risk factors, etiologies and outcomes in young patients with intracerebral hemorrhage (ICH).

Background:

Racial and ethnic disparities in risk and outcomes following ICH are well established, but less is known about ICH outcomes in younger patients. As ICH is associated with a high short-term and long-term morbidity and mortality, and has a rising incidence in younger patients, it is important to assess for disparities in its risk factors and outcomes.

Design/Methods:

We identified patients aged 18-50 from our stroke registry with non-traumatic ICH from 10/2016 to 11/2019. Baseline characteristics were abstracted, and ICH risk factors, etiologies and outcomes were compared between racial and ethnic groups. Independent samples t-test and chi-squared test were utilized for continuous and categorical outcomes, respectively.

Results:

Among 619 patients, 29% were non-Hispanic White (NHW), 32% non-Hispanic Black (NHB), 31% Hispanic (HIS), 5% Asian, and 4% other.  HIS were less insured (51.9%) compared to NHB (66.7%) and NHW (71.2%), and least likely to have a PCP (39.2%; p<0.01). NHB were most likely single (54.4%; p = 0.02) and living alone (20.5%; p = 0.04)). Arrival systolic and diastolic BP were significantly higher in NHB vs NHW (p<0.01). Prior hypertension (69.7%); diastolic dysfunction (24.6%); and moderate (17.4%) and severe left ventricular hypertrophy) were more common in NHB vs NHW and HIS. Reduced ejection fraction was more common in NHB (13.8%) and HIS (7.9%) vs NHW (1.7%). Hypertensive etiology was more likely in NHB (65.1%, p<0.01) vs NHW (46.9%) and HIS (52.9%). Inpatient mortality was 20.9% in NHW, 16.4% in NHB, and 18.0% in HIS. Inpatient mortality, discharge disposition, and discharge mRs did not differ between groups.  

Conclusions:

We found sociodemographic and risk factor differences in this young ICH cohort, which may underlie racial and ethnic differences in risk and outcomes.