Abstract Details

Title Predictors and outcomes of Intra Cerebral Hemorrhage among End Stage Renal Disease patients: a national perspective

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P12 - Poster Session 12 (12:00 PM-1:00 PM)

Poster/Presentation
Number 4-014

Objective Our aim is to determine the trends, predictors, and outcomes of Intracerebral Hemorrhage (ICH) in patients on maintenance dialysis/End Stage Renal Disease(ESRD) from a nationally representative sample.

Background Chronic kidney disease (CKD) patients are at higher risk of developing hemorrhage and associated with poor outcomes. ICH could result in higher mortality and morbidity in such patients. Management of ICH is perticularly challenging among ESRD patients on dialysis. However, very few studies estimated the risk and outcomes of ICH amongst ESRD patients from a larger population.

Design/Methods We derived the study cohort from the Nationwide Inpatient Sample for years 2005-2016. Adult Hospitalizations with ESRD were identified using International Classification of Diseases(9th Edition) Clinical Modification (ICD-9-CM) and ICD-10-CM diagnosis codes. ICH, commodities and complications were identified by using previously validated ICD-9-CM and ICD-10-CM diagnosis codes. We then utilized the Cochrane-Armitage trend test and multivariate survey logistic regression to analyze temporal trends, predictors, and outcomes.

Results Out of a total of 9,274,014 hospitalizations of ESRD patients, 31,109 (0.3%) admissions occurred due to ICH. Temporal trends over the study period mildly increased from 0.3% to 0.4%. Significant demographic predictors for developing ICH amongst ESRD patients were Hispanic (OR 1.20; 95%CI 1.09-1.35;p<0.001) and other ethnicity (OR 1.59; 95%CI 1.39-1.81; p<0.001), being uninsured (OR 1.29; 95%CI 1.26-1.40; p<0.001). Additionally commodities like hypertension (OR 6.56; 95%CI 5.48-7.86;p<0.001), alcoholism (OR 1.75; 95%CI 1.41-2.19; p<0.001), illicit drugs (OR 1.29; 95%CI 1.07-1.57;p<0.001), diabetes and cancer were also significantly associated with developing ICH. Moreover, ESRD individuals who were admitted due to ICH had higher odds of in-hospital mortality (OR 7.03;95%CI 6.39-7.71;p<0.001) and discharge to specialized care (OR 4.78;95%CI 4.32-5.29;p<0.001).

Conclusions

Our study demonstrates risk, predictors and outcomes of ICH among ESRD individuals over the past decade. Further studies are required to better risk stratify this population based on predictors in order to improve outcomes.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Abhishek Lunagariya, MD	No disclosure on file

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Abstract Details