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Abstract
Objective: To compare outcomes after intracerebral hemorrhage (ICH) from cerebral arteriovenous malformation (AVM) rupture and other causes of ICH.
Methods: We performed a retrospective population-based study using data from the Nationwide Inpatient Sample. We used standard diagnosis codes to identify ICH cases from 2002 to 2011. Our predictor variable was cerebral AVM. Our primary outcomes were inpatient mortality and home discharge. We used logistic regression to compare outcomes between patients with ICH with and without AVM while adjusting for demographics, comorbidities, and hospital characteristics. In a confirmatory analysis using a prospective cohort of patients hospitalized with ICH at our institution, we additionally adjusted for hematoma characteristics and the Glasgow Coma Scale score.
Results: Among 619,167 ICH hospitalizations, the 4,485 patients (0.7%, 95% confidence interval [CI] 0.6–0.8) with an AVM were younger and had fewer medical comorbidities than patients without AVM. After adjustment for confounders, patients with AVM had lower odds of death (odds ratio [OR] 0.5, 95% CI 0.4–0.7) and higher odds of home discharge (OR 2.0, 95% CI 1.4–3.0) than patients without AVM. In a confirmatory analysis of 342 patients with ICH at our institution, the 34 patients (9.9%, 95% CI 7.2–13.6) with a ruptured AVM had higher odds of ambulatory independence at discharge (OR 4.4, 95% CI 1.4–13.1) compared to patients without AVM.
Conclusions: Patients with ICH due to ruptured AVM have more favorable outcomes than patients with ICH from other causes.
GLOSSARY
- ARUBA=
- A Randomized Trial of Unruptured Brain Arteriovenous Malformations;
- AVM=
- arteriovenous malformation;
- CAESAR=
- Cornell Acute Stroke Academic Registry;
- CI=
- confidence interval;
- ICD-9-CM=
- International Classification of Diseases, Ninth Revision, Clinical Modification;
- ICH=
- intracerebral hemorrhage;
- NIS=
- Nationwide Inpatient Sample;
- OR=
- odds ratio
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 1878
- Received September 20, 2016.
- Accepted in final form January 11, 2017.
- © 2017 American Academy of Neurology
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