A Double-Hit: End-Stage Renal Disease Patients Suffer Worse Outcomes in Intracerebral Hemorrhage

Authors

Aiden K. Lui, School of Medicine at New York Medical College, Valhalla, New York USA.
Fangyi Lin, School of Medicine at New York Medical College, Valhalla, New York USA.
Anaz Uddin, School of Medicine at New York Medical College, Valhalla, New York USA.
Bridget Nolan, School of Medicine at New York Medical College, Valhalla, New York USA.
Kevin Clare, School of Medicine at New York Medical College, Valhalla, New York USA.
Terry Nguyen, School of Medicine at New York Medical College, Valhalla, New York USA.
Eris Spirollari, School of Medicine at New York Medical College, Valhalla, New York USA.
Eric Feldstein, Brain and Spine Institute at Westchester Medical Center, Valhalla, New York USA.
Yarden Bornovski, Brain and Spine Institute at Westchester Medical Center, Valhalla, New York USA.
Jose Dominguez, Brain and Spine Institute at Westchester Medical Center, Valhalla, New York USA.
George Coritsidis, Department of Nephrology at Westchester Medical Center, Valhalla, New York USA.
Chirag D. Gandhi, School of Medicine at New York Medical College, Valhalla, New York USA.
Fawaz Al-Mufti, School of Medicine at New York Medical College, Valhalla, New York USA.Follow

Author Type(s)

Student, Resident/Fellow, Faculty

DOI

10.4103/bc.bc_24_23

Journal Title

Brain Circulation

First Page

172

Last Page

177

Document Type

Article

Publication Date

1-1-2023

Department

Neurosurgery

Second Department

Neurology

Third Department

Medicine

Abstract

BACKGROUND: Intracerebral hemorrhage (ICH) carries significant morbidity and mortality. Previous single-center retrospective analysis suggests that end-stage renal disease (ESRD) is a risk factor for severe ICH and worse outcomes. This investigation aims to examine the impact of ESRD on ICH severity, complications, and outcomes using a multicenter national database. METHODS: The International Classification of Disease, Ninth and Tenth Revision Clinical Modification codes were used to query the National Inpatient Sample for patients with ICH and ESRD between 2010 and 2019. Primary endpoints were the functional outcome, length of stay (LOS), and in-hospital mortality. Multivariate variable regression models and a propensity-score matched analysis were established to analyze patient outcomes associated with baseline patient characteristics. RESULTS: We identified 211,266 patients with ICH, and among them, 7,864 (3.77%) patients had a concurrent diagnosis of ESRD. Patients with ESRD were younger (60.85 vs. 67.64, P < 0.01) and demonstrated increased ICH severity (0.78 vs. 0.77, P < 0.01). ESRD patients experienced higher rates of sepsis (15.9% vs. 6.15%, P < 0.01), acute myocardial infarction (8.05% vs. 3.65%, P < 0.01), and cardiac arrest (5.94% vs. 2.4%, P < 0.01). In addition, ESRD predicted poor discharge disposition (odds ratio [OR]: 2.385, 95% confidence interval [CI]: 2.227-2.555, P < 0.01), longer hospital LOS (OR: 1.629, 95% CI: 1.553-1.709, P < 0.01), and in-hospital mortality (OR: 2.786, 95% CI: 2.647-2.932, P < 0.01). CONCLUSIONS: This study utilizes a multicenter database to analyze the effect of ESRD on ICH outcomes. ESRD is a significant predictor of poor functional outcomes, in-hospital mortality, and prolonged stay in the ICH population.

Recommended Citation

Lui, A. K., Lin, F., Uddin, A., Nolan, B., Clare, K., Nguyen, T., Spirollari, E., Feldstein, E., Bornovski, Y., Dominguez, J., Coritsidis, G., Gandhi, C. D., & Al-Mufti, F. (2023). A Double-Hit: End-Stage Renal Disease Patients Suffer Worse Outcomes in Intracerebral Hemorrhage. Brain Circulation, 9 (3), 172-177. https://doi.org/10.4103/bc.bc_24_23