ArticleClinical neurology and neurosurgery2025
Medical complications associated with prolonged length of stay in patients with nontraumatic intracerebral hemorrhage: A nationwide cohort study.
Article in Clinical neurology and neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Cerebrospinal Fluid Hemopexin as a Candidate Biomarker for Secondary Sepsis and In-Hospital Outcome After Spontaneous Intracerebral Hemorrhage: An Exploratory Translational Proteomics Study.Neurocritical care · 2026Article
- Article
- Early gastrostomy is associated with more efficient healthcare resource utilization in nontraumatic intracerebral hemorrhage patients.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026Article
- Factors associated with ventilator-associated pneumonia and outcomes in mechanically ventilated patients with nontraumatic intracerebral hemorrhage: a real-world data analysis.Critical care science · 2026Article
- Risk factors for lower limb deep vein thrombosis in patients with intracerebral hemorrhage: a retrospective study using LASSO regression to develop a nomogram.Frontiers in neurologyArticle
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Abstract
purposeThis work aims to investigate the in-hospital medical complications associated with prolonged length of stay (PLOS) in a large cohort of patients with nontraumatic intracranial hemorrhage (ICH), using a nationwide inpatient sample.
methodsIn this retrospective cohort study, the National Inpatient Sample database was investigated for patients admitted with nontraumatic ICH from October 2015 to December 2022. Demographics, comorbidities, markers of ICH severity, in-hospital procedures, PLOS, and hospital mortality were noted. PLOS was defined as length of stay exceeding the 75th percentile of the entire cohort. Outcomes investigated were in-hospital medical complications, including acute ischemic stroke (AIS), seizures, aspiration pneumonia, acute respiratory failure, deep vein thrombosis (DVT), pulmonary embolism (PE), and acute kidney injury (AKI). Multivariable logistic models were used to determine the association between each preselected outcome and PLOS, adjusted for demographics, comorbidities, ICH severity, and surgical procedures. Significant P value was set at 0.05 for all analyses.
resultsOut of 211,879 ICH included in the study, 50,224 (23.7 %) had PLOS. PLOS was defined as a LOS that exceeded 12 days. ICH patients with PLOS were younger (63 [52-73] vs. 70 [58-80]), more likely to be male (56.1 % vs. 51.5 %), Black (25.9 % vs. 18.3 %) or Hispanic (12.4 % vs. 9.7 %), and being in the lower median household income quartile (31.9 % vs. 28.5 %), p < 0.01 for all. In distinct multivariable logistic models, adjusted for demographics, comorbidities, ICH severity, and surgical procedures, AIS (OR: 1.469, 95 %CI: 1.428-1.511), seizures (OR: 1.214, 95 %CI: 1.164-1.265), aspiration pneumonia (OR: 2.911, 95 %CI: 2.809-3.016), acute respiratory failure (OR: 1.527, 95 %CI: 1.48-1.576), DVT (OR: 2.739, 95 %CI: 2.568-2.921), PE (OR: 1.638, 95 %CI: 1.521-1.765), and AKI (OR: 2.037, 95 %CI: 1.978-2.098) were independently associated with PLOS, p < 0.01 for all. Age-stratified analysis revealed that the strongest association with PLOS was observed for DVT in patients < 40 years (OR 3.797, 95 % CI: 2.991-4.822) and for aspiration pneumonia in those ≥ 80 years (OR 3.508, 95 % CI: 3.242-3.795). Patients with PLOS experienced a lower in-hospital mortality rate (13.4 % vs. 22.8 %, p < 0.01).
conclusionsIn this large cohort of ICH patients, racial/ethnic minorities and lower-income patients were more likely to experience PLOS. PLOS was associated with both neurological and medical complications, with aspiration pneumonia showing the strongest association in older patients and DVT in younger patients. Prolonged hospitalization did not impact short-term mortality.
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