Intracerebral hemorrhage (ICH) in easternmost Finland 2021–2023

Abstract

Aim: To report the incidence, characteristics, and prognosis of spontaneous intracerebral hemorrhage (ICH) in North Karelia Central Hospital Primary Stroke Center (PSC).

Methods: All patients admitted with ICH to North Karelia Central Hospital between January 1, 2021, and August 8, 2023, were identified from the center’s prospectively updated stroke care database. Post-hospital care data on outcomes were retrospectively updated between May 27 and June 5, 2024.

Results: During the entire study period, we identified altogether 56 ICH patients, of whom two thirds were men. The mean annual incidence of 2021–2022 was 12.3/100,000, and in the population 19–49 years of age, 1.8/100,000. Three months after the stroke, 50% of the patients were functionally independent. In-hospital mortality was 5%, and altogether 11 patients (20%) died during the follow-up (mean 1.72 years). In multivariate analyses, diabetes was associated with mortality [hazard ratio: 3.50, 95% confidence interval (CI): 1.02–11.95], and age was associated with functional outcome in three-month follow-up (odds ratio: 1.060, 95% CI: 1.015–1.107). New-onset epilepsy was diagnosed in three patients (6%) during the follow-up (mean: 1.84 years).

Conclusions: Short-term functional outcome of ICH was mostly favorable, continuing long-term trends of improving outcomes after stroke. Efficacy of multiple interventions care bundle in the treatment of ICH in a PSC-level hospital, a shift of using direct oral anticoagulants (DOACs) instead of warfarin, and improved health status of elderly citizens could be contributing to the better outcome.

Keywords

Cerebrovascular disease / outcome / prognosis / stroke / survival / hemorrhagic stroke

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