Abstract TP155: Examining Intersectionality of Sex and Race-Ethnicity in Acute Hemorrhagic Stroke among Young Adults

Background: Although intracerebral hemorrhage (ICH) represents only ~13% of all strokes in the United States, it carries high morbidity and mortality. Data on sex-based differences in ICH remains limited. Men more often present with hypertension, while women are more likely to have vascular malformations and worse outcomes despite smaller bleeds. Black and Hispanic young adults experience higher ICH incidence and mortality than Whites, with hypertension being a key risk factor. This study explores how intersecting factors of sex and race-ethnicity relate to outcomes such as inpatient mortality and discharge disposition among young ICH patients treated at a comprehensive stroke center Methods: We identified patients aged 18–50 with non-traumatic ICH from our stroke registry between 10/2016 and 11/2019. Baseline socio-demographic, clinical characteristics, and outcomes were compared across groups. Logistic and multinomial logistic regressions were used, as appropriate, to assess predictors of mortality and discharge disposition. Results: Among 619 patients, 63.8% were male and 36.2% female. The average age of the cohort was 40.3 years (SD: 8.4). The cohort included 195 Non-Hispanic Black, 156 Non-Hispanic White, 33 Asian, 189 Hispanic, and 46 Non-Hispanic other patients. Admission creatinine ranged from 0.46–3.09 mg/dL; glucose from 76–233 mg/dL. Elevated admission glucose and creatinine were associated with increased inpatient mortality (OR=1.01, p<0.001 and OR=1.2, p=0.03, respectively). Elevated glucose was also associated with higher rates of discharge to inpatient settings as compared with discharge to home (OR=1.01, p<0.001). Hispanic males had significantly lower odds of inpatient mortality (OR=0.43, p=0.031) compared with non-Hispanic White males. Having a primary care provider was linked to reduced mortality risk (OR=0.38, p<0.001). Conclusion: Higher admission glucose and creatinine levels in young adults with ICH were associated with increased inpatient mortality and unfavorable discharge dispositions, while access to primary care was protective. Hispanic male patients had better outcomes despite higher baseline glucose and creatinine. Apart from sex and Hispanic heritage, no association between the intersectionality of sex and race-ethnicity, and study outcomes were observed.