Background: Nontraumatic intracranial hemorrhages (ICH) are serious cerebrovascular events with high morbidity and mortality. While ICH continues to be a focus of research in the medical community, there is little data on the differences in outcomes by gender. We aimed to further investigate these differences in our study.
Methods: This is an Institutional Review Board (IRB) approved observational cohort study of de-identified patient data obtained from our central billing system comprising over 176 hospitals in the United States with over 8.6 million emergency department visits annually. Outcome variables included length of stay, mortality, and disposition. Logistic regression analyses were performed using JMP 14.0 for the Mac.
Results: All patients (n=8096) with a diagnosis of intracranial hemorrhage in the top three diagnosis codes were included in the study and there were no exclusion criteria. The cohort was 81% Caucasian, 15% black, and 4% Hispanic. 48% of patients were female with a median age of 71 years. 52% of patients were male with a median age of 65. One fifth of the cohort (20%) died while another fifth (21%) were discharged home. 13% joined hospice. Women were significantly more likely to die (P=0.0185) or to join hospice (P= 3.4%) even after controlling for age and ethnicity. Women also had significantly shorter length of stay (P=0.0002, 95% CI -1.58 to -0.489, R2= 1.5%) at 4 days for men and 3 days for women, controlled for age.
Conclusion: The median age for women with nontraumatic ICH is older than men, which could explain their increased rates of mortality and discharge to hospice. Even when controlled for age, women were significantly less likely to be discharged home.