Impact of Preexisting dementia on in-hospital clinical outcomes in patients with intracerebral hemorrhage stroke

ObjectiveWe assessed the impact of preexisting dementia on in-hospital mortality, home discharge and complications of Chinese patients with intracerebral hemorrhage (ICH). MethodsConsecutive in-hospital data were extracted from the China Stroke Center Alliance database from August 2015 to July 2019. Patient characteristics, in-hospital mortality, and complications were compared between ICH patients with and without preexisting dementia. ResultsOut of the eligible 72,318 patients with ICH, we identified 328 patients with pre-existing dementia. Compared with patients without dementia, those in the dementia group were older, more females and a higher proportion of individuals with lower education, and a history of diabetes, myocardial infarction, stroke, heart failure, peripheral vascular disease and cigarette smoking. Those with pre-existing dementia group were more prone to a greater stroke severity as measured by the National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) at presentation. In the adjusted models, the presence of preexisting dementia was associated with an increased risk of in-hospital mortality (OR 2.31, 95% CI 1.12-4.77) and more frequent in-hospital complications of pulmonary embolism (OR 5.41, 95% CI 1.16-25.14), pneumonia (OR 1.58, 95% CI 1.08-2.33), urinary tract infection (OR 2.37; 95% CI 1.21-4.64), and gastrointestinal bleeding (OR 2.39, 95% CI 1.27-4.49). ConclusionsICH patients with pre-existing dementia are more prone to more severe strokes and poorer outcomes. Future studies should evaluate the value of intensive risk factor control among individuals with pre-existing dementia for stroke prevention.