Abstract W MP112: Factors Associated With Increased In-Hospital Mortality Among Children With Intracerebral Hemorrhage
Objective: Prior reports have noted that intracerebral hemorrhage (ICH) volume and altered mental status predict poor outcome in children but assessment of other predictors has been limited by sample size. We assessed predictors of mortality and potential targets for intervention in a large national sample of children with non-traumatic ICH.
Methods: Using the Healthcare Cost and Utilization Project Kids’ Inpatient Database, ICD-9-codes (431, 432.9) identified children 1-18 years with non-traumatic ICH in years 2003, 2006 and 2009. Children with ICD-9 codes for trauma (800s) were excluded. Step-wise logistic regression determined factors associated with mortality. The Cochran-Armitage trend test determined the change in annual average mortality and hospitalization days from 2003 to 2009.
Results: ICH was the primary diagnosis for 2346 children over the 3-year sample (Table). The most common comorbidities included coagulopathy (11.4%), AVM (10.5%) and hypertension (8%). Overall, 8.7% died in the hospital. Factors associated with mortality included Hispanic ethnicity (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.2-2.8), older age 11-18 years (OR 1.7, 95% CI 1.2-2.5), coagulopathy (OR 3.8, 95% CI 2.4-6.1), hypertension (OR 2.1, 95% CI 1.2-3.9) and coma (OR 12, 95% CI 5.3-30.7). Mortality decreased from 10.6% in 2003 to 7.2% in 2009 (p<0.01). Mean length of stay increased from 7 days (95% CI 6-9 days) in 2003 to 9 days (95% CI 8-10 days) in 2009 (p<0.001).
Conclusion: Coma, coagulopathy, and hypertension demonstrated a strong association with mortality among children with ICH and may represent potential targets for therapeutic intervention.
Author Disclosures: M.M. Adil: None. A.I. Qureshi: None. L.A. Beslow: None. A.A. Malik: None. L.C. Jordan: Research Grant; Significant; NIH K23NS062110.
- © 2014 by American Heart Association, Inc.