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

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

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 gender groups across different ethnic groups. Independent samples t-test and chi-squared test were utilized for continuous and categorical outcomes, respectively.

Among 619 patients, 64% were males and 36% were female. Men were slightly older than women (41.0±8.2 years vs 39.0 ±8.6 years respectively; p<0.01).  More women were insured compared to men (71.4% vs 61.8%, p=0.03). More women had access to primary care compared to men (51.8% vs 41.8%, p<0.01). Arrival systolic and diastolic BP were significantly higher in men vs women (p<0.01). Male had higher odds of having prior hypertension, smoking and alcohol abuse history compared to females (p<0.01). Compared to men, women had higher odds of having vascular cause as an etiology for ICH [OR 2.21 (1.24 -3.04)]. More men had urine drug screen completed on admission compared to women (83.5% vs 68.8%, p<0.01). Inpatient mortality, discharge disposition, and discharge mRs did not differ between sex groups.  

We found sociodemographic and risk factors differences in this young ICH cohort, which may underlie sex differences in risk and outcomes.