Trends and Predictors of Outcomes of Primary Intracerebral Hemorrhage in Very Elderly Patients.

Abstract

Introduction Primary intracerebral hemorrhage (ICH) is known to have poor management outcome. Very elderly patients (age > 80) might have 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 octogenarians and compare the inpatient management outcomes with younger counterparts. Methods The Stony Brook ICH database is a retrospective cohort of 814 patients that presented with primary ICH from January 2011 to January 2021. Demographic data, presenting symptoms, pre-existing medical conditions, and imaging findings were recorded. Inpatient outcomes and functional state presented as modified Rankin Scale (MRS) at discharge were evaluated. Results Our results indicate octogenarians had significantly higher baseline MRS and comorbidities such as hypertension, hyperlipidemia, and atrial fibrillation at presentation. Similarly, usage of statins, antiplatelets, and anticoagulants were significantly higher in this age group. Octogenarians were also found to have higher average volume of hematoma at presentation. Our results indicate significantly higher discharge MRS, and inpatient mortality in the very elderly group. Conclusion Present study demonstrates a wide variety of pre-existing factors that correlate with worse outcomes amongst octogenarians presenting with primary ICH. Given the importance of aging population as a major healthcare issue in many parts of world, it is crucial to continue exploring these associations in future research. Findings of this study can be utilized to plan further prospective studies on this topic.