Abstract
Background: We report contemporary trends in nationwide incidence of intracerebral hemorrhage (ICH) across demographic and regional strata over a 15-year period. Methods: Utilizing the Nationwide Inpatient Sample (2004-2018) and US Census Bureau data, we calculated ICH incidence rates for age, race/ethnicity, sex, and hospital region sub-cohorts across 5 consecutive 3-year periods (2004-2006 to 2016-2018). We fit Poisson and log binomial regression models to evaluate demographic and regional differences in ICH incidence and trends in prevalence of hypertension and past/current anticoagulant use among hospitalized ICH patients. Results: Overall, the annual incidence rate (95% CI) of ICH per 100 000 was 23.15 (23.10-23.20). The 3-year incidence of ICH (per 100 000) increased from 62.79 in 2004 to 2006 to 78.86 in 2016 to 2018 (adjusted incidence rate ratio, CI: 1.11 [1.02-1.20]), coinciding with increased 3-year prevalence of hypertension and anticoagulant use among hospitalized ICH patients (adjusted risk ratio, CI: hypertension - 1.16 [1.15-1.17]; anticoagulant use - 2.30 [2.14-2.47]). We found a significant age-time interaction, whereby ICH incidence increased significantly faster among those aged 18 to 44 years (adjusted incidence rate ratio, CI: 1.10 [1.05-1.14]) and 45 to 64 years (adjusted incidence rate ratio, CI: 1.08 [1.03-1.13]), relative to those aged ≥75 years. Conclusions: Rising ICH incidence among young and middle-aged Americans warrants ICH prevention strategies targeting these economically productive age groups.
Original language | English (US) |
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Pages (from-to) | E70-E74 |
Journal | Stroke |
Volume | 53 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2022 |
Keywords
- anticoagulant
- cerebral hemorrhage
- hospital
- hypertension
- incidence
- prevalence
- stroke
- Prevalence
- Humans
- Middle Aged
- Hypertension/epidemiology
- Male
- Cerebral Hemorrhage/epidemiology
- Incidence
- Young Adult
- United States/epidemiology
- Adolescent
- Aged, 80 and over
- Adult
- Female
- Aged
- Odds Ratio
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialized Nursing