(673) Impact of Early Intervention on 6-Month Survival in Intracerebral Hemorrhage

Introduction: Intracerebral hemorrhage (ICH) is the most devastating stroke subtype with high rates of mortality and disability. Early interventions, such as rapid blood pressure (BP) control and anticoagulation reversal, are hypothesized to limit hematoma expansion and improve patient outcomes.

Methods: A 6-month retrospective cohort study of patients admitted with ICH was conducted at Baptist Health. Data included patient demographics, hemorrhage type, time to intervention, and clinical outcomes. Key interventions were BP control and anticoagulation reversal. Data were categorized based on time to achieve SBP < 160 mmHg and < 140 mmHg, and time to anticoagulation reversal. Statistical analyses was performed using AI and included chi-squared tests to compare outcomes (alive vs. expired) across different intervention time categories and demographic groups.

Results: The study included 155 patients (74 men, 81 women) with an mean age of 66.36 years. Hemorrhage subtypes included 75 intraparenchymal hemorrhage, 39 subdural hematoma, 37 subarachnoid hemorrhage, and 2 traumatic brain injury. Overall mortality was 20%, with 31 deaths.

Analysis of time to SBP control revealed no statistically significant difference in 6-month outcomes based on time to SBP < 160 mmHg (p=1.0) or < 140 mmHg (p=1.0). Time to anticoagulation reversal categorized into < 1hr, 1-2hr, and 2-3hr also showed no significant association with 6-month survival (p=0.364).

Demographic analysis showed that age nor sex significantly impacted 6-month survival. Specifically, the chi-squared test for age categories yielded a p-value of 0.425, and the test for sex p-value 0.673. Bleed subtype was also not significantly associated with survival (p-value 0.406).

Conclusions: In our patients, early intervention, including SBP control and anticoagulation reversal, did not show a statistically significant impact on 6-month survival outcomes. Demographic factors such as age, sex, and bleed type also did not influence survival rates. These findings suggest that while early management protocols may be important, they may not effect patient survival as hypothesized. Further research is needed to identify and address which factors can improve survival rates in ICH patients.