Abstract NS20: Discharge Disposition After Intracerebral Hemorrhage
Introduction: We sought to explore factors that determine discharge disposition after ICH to home-like environment vs. medical facility in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study.
Methods: ERICH is a multi-center, prospective case-control study of ICH among white, black, and Hispanic patients. Hospital discharge data at 19 study centers were collected through chart review. Analysis was restricted to those with pre-stroke modified Rankin Scale (mRS) < 3, available ICH volume, and survivors. ICH volumes were log transformed to minimize the influence of extreme values on modeling.
Results: Between 8/1/10 and 12/31/13, 2276 ICH cases were enrolled, of whom 1499 qualified for analysis (564 black, 513 Hispanic, and 422 white). Univariate analysis examined demographics, past medical history, ICH location, discharge mRS, intraventricular extension, social status (education level, marital. status, employment), and type of insurance. Of the 1499 cases, 541 (36.1%) were discharged to home-like settings (home, relative, or friend) and 958 (63.9%) to medical care (rehabilitation, skilled nursing facility), assisted living, hospital/acute care). In multivariable modeling (Table), significant predictors of discharge disposition were measures of severity (i.e., ICH volume, Glasgow Coma Scale) and ICH location. In addition, types of insurance, age, and ethnicity were significant. Specifically, black ICH cases were more likely to go to a medical facility than Hispanics rather than discharge to home after controlling for severity measures.
Conclusion: Age, ethnicity and insurance status were independent predictors of discharge to a medical facility rather than to home even after controlling for stroke severity measures of ICH volume and presenting GCS. Future analysis is needed to look at 3 month functional outcome was affected by the discharge disposition.
Author Disclosures: J. Osborne: Research Grant; Significant; NIH NS 069763. C.D. Langefeld: Research Grant; Significant; NIH NS 069763. C.J. Moomaw: Research Grant; Significant; NIH NS 069763. K.N. Sheth: Research Grant; Significant; American Heart Association Clinical Research Award. D.Y. Hwang: None. M.L. Flaherty: Research Grant; Significant; NIH NS 069763, NINDS 2P50NS044283-06. Other Research Support; Significant; STOP-IT Study. Speakers' Bureau; Modest; CSL Behring. A. Vashkevich: Research Grant; Significant; NIH NS 069763. J. Gohs: Research Grant; Significant; NIH NS 069763. D. Woo: Research Grant; Significant; NIH NS 069763.
- © 2015 by American Heart Association, Inc.