E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Association of Pre-existing Comorbidities with Inpatient Outcomes in Very Elderly Patients Presenting with Primary Intracerebral Hemorrhage
Kevin Gilotra✉ ,
Melissa Janssen ,
Xiaoyue Zhang ,
Racheed Mani ,
Sujith Swarna ,
Cassie Wang ,
Reza Dashti
DOI: 10.5137/1019-5149.JTN.48712-25.1
Article in Press
Corresponding Author:
Kevin Gilotra (kevin.gilotra@stonybrookmedicine.edu)
Abstract
Aim
Primary intracerebral hemorrhage (ICH) is known to have poor management outcomes. Very elderly patients (age > 80) might have a significantly higher incidence of worse management morbidity and mortality after primary ICH. The aim of this study was to explore presenting status and pre-existing comorbidities in very elderly patients and compare the inpatient management outcomes with younger counterparts.
Material and Methods
The Stony Brook ICH database is a retrospective cohort of 814 patients who presented with primary ICH from January 2011 to January 2021. Demographic data, presenting symptoms, pre-existing medical conditions, and imaging findings were recorded. Functional state presented as modified Rankin Scale (MRS) at discharge and inpatient mortality were evaluated.
Results
Our results indicate very elderly patients had significantly higher baseline MRS and comorbidities such as hypertension, hyperlipidemia, and atrial fibrillation at presentation. Similarly, usage of statins, antiplatelets, and anticoagulants was considerably higher in this age group. Very elderly patients were also found to have a higher average volume of hematoma at presentation (p-value 0.0220). Our results indicate that patients with age > 80 have a significantly lower likelihood of having a good clinical mRS score at discharge compared to younger patients (Adjusted OR 0.251, p-value = 0 0.0026).
Conclusion
The present study demonstrates a wide variety of pre-existing factors that correlate with worse outcomes amongst very elderly patients presenting with primary ICH. Given the importance of an aging population as a major healthcare issue in many parts of the world, it is crucial to continue exploring these associations in future research. The findings of this study can be utilized to plan further prospective studies on this topic.
Primary intracerebral hemorrhage (ICH) is known to have poor management outcomes. Very elderly patients (age > 80) might have a significantly higher incidence of worse management morbidity and mortality after primary ICH. The aim of this study was to explore presenting status and pre-existing comorbidities in very elderly patients and compare the inpatient management outcomes with younger counterparts.
Material and Methods
The Stony Brook ICH database is a retrospective cohort of 814 patients who presented with primary ICH from January 2011 to January 2021. Demographic data, presenting symptoms, pre-existing medical conditions, and imaging findings were recorded. Functional state presented as modified Rankin Scale (MRS) at discharge and inpatient mortality were evaluated.
Results
Our results indicate very elderly patients had significantly higher baseline MRS and comorbidities such as hypertension, hyperlipidemia, and atrial fibrillation at presentation. Similarly, usage of statins, antiplatelets, and anticoagulants was considerably higher in this age group. Very elderly patients were also found to have a higher average volume of hematoma at presentation (p-value 0.0220). Our results indicate that patients with age > 80 have a significantly lower likelihood of having a good clinical mRS score at discharge compared to younger patients (Adjusted OR 0.251, p-value = 0 0.0026).
Conclusion
The present study demonstrates a wide variety of pre-existing factors that correlate with worse outcomes amongst very elderly patients presenting with primary ICH. Given the importance of an aging population as a major healthcare issue in many parts of the world, it is crucial to continue exploring these associations in future research. The findings of this study can be utilized to plan further prospective studies on this topic.
Keywords
intracerebral hemorrhage
very elderly
outcomes