Abstract WP135: Impact Of End Stage Renal Disease On Outcomes After Intracerebral Hemorrhage - A Nationwide Analysis

Autor: Aiden Lui, Harli Weber, Marco Salazar, Adonai Sebastian, Alexandria Naftchi, Theresa Henson, Fawaz Al-Mufti, Stephan Mayer
Rok vydání: 2022
Předmět:
Zdroj: Stroke. 53
ISSN: 1524-4628
0039-2499
DOI: 10.1161/str.53.suppl_1.wp135
Popis: Introduction: Intracerebral hemorrhage (ICH) is a devastating form of stroke that is usually related to chronic hypertension. End stage renal disease (ESRD) requiring renal replacement therapy (RRT) often leads to chronic hypotension, and fluid shifts during dialysis might increase the severity of brain edema. We sought to better understand the impact of ESRD on outcomes after ICH, with a focus of the presence of hypertension or hypotension during hospitalization. Methods: We analyzed the National Inpatient Sample (NIS) database and extracted all cases of ICH (ICD-9 431 or ICD-10 I61) between 2012 and 2017. Patients were classified as requiring RRT (ICD9: V56, V4511, 5856; ICD 10: N186, Z49, Z992) or not. We also noted the presence of codes for hypertension, hypotension, or cerebral herniation. The main outcome measure was death at discharge. Logistic regression was used to calculate odds ratios for mortality with adjustment for ICH severity using a compilation of codes for common complications. Results: 116,812 ICH patients were identified, 3,329 (2.8%) of whom received RRT. Mortality in the non-RRT group was 18% as opposed to 32% in the RRT group (severity adjusted odds ratio 2.1, 95% CI 2.0–2.3, P Conclusion: ESRD requiring RRT is associated with a 78% relative increase in mortality after ICH. Whereas hypotension increases the risk of death in ICH patients with preserved renal function, hypotension is much more common in ESRD patients and does not confer the same hazard. Further research is needed to understand how ESRD increases mortality after ICH.
Databáze: OpenAIRE