High-Volume Hospital Had Lower Mortality of Severe Intracerebral Hemorrhage Patients
- Author:
Sang-Won PARK
1
;
James Jisu HAN
;
Nam Hun HEO
;
Eun Chae LEE
;
Dong-Hun LEE
;
Ji Young LEE
;
Boung Chul LEE
;
Young Wha LIM
;
Gui Ok KIM
;
Jae Sang OH
Author Information
- Publication Type:Clinical Article
- From:Journal of Korean Neurosurgical Society 2024;67(6):622-636
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:: Intracerebral hemorrhage (ICH) accompanies higher mortality rates than other type of stroke. This study aimed to investigate the association between hospital volume and mortality for cases of ICH.
Methods:: We used nationwide data from 2013 to 2018 to compare high-volume hospitals (≥32 admissions/year) and low-volume hospitals (<32 admissions/year). We tracked patients’ survival at 3-month, 1-year, 2-year, and 4-year endpoints. The survival of ICH patients was analyzed at 3-month, 1-year, 2-year, and 4-year endpoints using Kaplan-Meier survival analysis. Multivariable logistic regression analysis and Cox regression analysis were performed to determine predictive factors of poor outcomes at discharge and death.
Results:: Among 9086 ICH patients who admitted to hospital during 18-month period, 6756 (74.4%) and 2330 (25.6%) patients were admitted to high-volume and low-volume hospitals. The mortality of total ICH patients was 18.25%, 23.87%, 27.88%, and 35.74% at the 3-month, 1-year, 2-year, and 4-year, respectively. In multivariate logistic analysis, high-volume hospitals had lower poor functional outcome at discharge than low-volume hospitals (odds ratio, 0.80; 95% confidence interval, 0.72–0.91; p<0.001). In the Cox analysis, high-volume hospitals had significantly lower 3-month, 1-year, 2-year, and 4-year mortality than low-volume hospitals (p<0.05).
Conclusion:: The poor outcome at discharge, short- and long-term mortality in ICH patients differed according to hospital volume. High-volume hospitals showed lower rates of mortality for ICH patients, particularly those with severe clinical status.
