2025 American Academy of Neurology Abstract Website

Objective:

This study investigates demographic, clinical and socioeconomic variables associated with discharge disposition and functional outcomes in intracerebral hemorrhage (ICH) patients from different racial backgrounds.

Background:

Black and Hispanic Americans have a higher incidence rate of ICH, have their events at a younger age, and yet have better outcomes after ICH as compared with White Americans, potentially related to their younger age. This analysis aims to explore the hypothesis that variable discharge disposition by race/ethnicity effects outcomes after ICH.

Design/Methods:

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study was a prospective, multicenter, longitudinal study of ICH. We conducted a univariate comparison of race/ethnic groups, age, sex, ICH risk factors and imaging characteristics (location, volume, and presence of IVH), admission Glasgow coma scale (GCS), discharge disposition, 3 month modified Rankin score (mRS) and household size. A multivariate model for home discharge as the dependent variable was computed with covariates of ICH score, insurance status, race and number of family members.

Results:

There were 2138 patients with ICH who met inclusion criteria for this study. In univariate analysis, Hispanic and Black participants had significantly worse admission GCS as compared to white patients (p=0.036). Hispanic patients were more likely than African American and White patients to be discharged home (p=0.029). Multivariate modeling showed that lower ICH score (OR 0.46 [95% CI 0.41,0.52], p<0.0001) and lack of insurance (OR 0.66 [95% CI0.53,0.81], p=0.0001) were the most important variables associated with discharge to home. Despite this, there were no significant differences in the mRS across all racial groups at 3 months (p=0.65).

Conclusions:

Despite similar stroke severity measures with respect to age, volume and presenting severity, Hispanic patients were more likely to be discharged to home with insurance status and severity as the strongest independent predictors. However, outcomes were not affected by the variation in discharge disposition.