Background: Clinical characteristics and outcomes for patients with intracerebral hemorrhage and underlying chronic kidney disease (CKD) are not well determined. We hypothesized rate adverse events and in-hospital mortality is higher in patients with intracerebral hemorrhage and underlying renal disease.
Objective: To determine the Outcomes for intracerebral hemorrhage stroke patients with renal failure as comorbidity in the United States
Methods: We analyzed the data from Nationwide Inpatient Sample (2009-2011) for all intracerebral hemorrhage stroke patients with or without renal failure as comorbidity. Patients were identified using the International Classification of Disease, Ninth Revision. Baseline characteristics, in-hospital complications including myocardial infarction), sepsis, pneumonia, deep venous thrombosis, urinary tract infections, and discharge outcomes (mortality, minimal disability, and moderate-to-severe disability) were compared between the two groups. All in-hospital outcomes were analyzed after adjusting for potential confounders using multivariate analysis.
Results: Of the 33521 patients with intracerebral hemorrhage stroke, 3899 (11.6%) had renal failure as comorbidity. Patients with underlying renal disease were higher rates for in hospital complications like myocardial infarction (3.64% versus 2.03%, P≤.0001), sepsis (5.82% versus 3.14%, P≤.0001), pneumonia (6.92% versus 5.18%, P≤.0001), deep venous thrombosis (1.67 % versus 1.17%, P≤ .0.0078), urinary tract infections (16.41% versus 15.08%, P≤ 0.0293) and hypernatremia (8.62% versus 4.98%, P≤ <.0001). In multivariate analysis adjusted for baseline cormorbitdities and in hospital complications, intracerebral hemorrhage patients with underlying renal disease had higher in hospital mortality (OR 1.146 (95% confidence interval (CI)1.058- 1.240p-value=0.0008), while there is no statistically significant difference for minimal/moderate disability between two groups (OR = 0.980 (95% CI0.896- 1.072 p-value=0.6571).
Conclusions: Intracerebral hemorrhage patients with underlying renal disease have higher rate of in hospital complications and mortality. Future prospective studies are indicated to study this finding.