title: Factors Associated With Increased In-Hospital Mortality Among Children With Intracerebral Hemorrhage.
abstract: We assessed factors associated with mortality and potential targets for intervention in a large national sample of children with nontraumatic intracerebral hemorrhage. Using Healthcare Cost and Utilization Project Kids' Inpatient Database ICD-9-CM code 431 identified children aged 1 to 18 years with nontraumatic intracerebral hemorrhage in 2003, 2006 and 2009. Intracerebral hemorrhage was the primary diagnosis for 1172 children (ages 1-18 years) over the 3-year sample. Factors associated with mortality based on multivariable logistic regression included Hispanic ethnicity (odds ratio 1.9, 95% confidence interval 1.1-3.3), older age (11-18 vs 1-10 years, odds ratio 2.5, 95% confidence interval 1.3-5.0), coagulopathy (odds ratio 3.0, 95% confidence interval 1.6-6.0), and coma (odds ratio 9.0, 95% confidence interval 3.2-24.6). From 2003 to 2009, there was a non-significant decrease in mortality with a significant increase in length of stay from 9 to 11 days (P < .003). In children with intracerebral hemorrhage, coma and coagulopathy had the strongest association with mortality; coagulopathy is a potentially modifiable risk factor.
authors.affiliation: Department of Internal Medicine and Neurology, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA, USA Zeenat Qureshi Stroke Institute, St Cloud, MN, USA malikmuhammad.adil@gmail.com.
authors.forename: Malik M
authors.initials: MM
authors.lastname: Adil
authors.affiliation: Zeenat Qureshi Stroke Institute, St Cloud, MN, USA.
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
authors.affiliation: Departments of Pediatrics and Neurology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Beslow
authors.affiliation: Zeenat Qureshi Stroke Institute, St Cloud, MN, USA.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Malik
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Lori C
authors.initials: LC
authors.lastname: Jordan
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: child; intracerebral hemorrhage; mortality