Abstract Number: Esoc2026a2396 Preliminary Analysis of the Relationship Between Health Insurance Status and Spontaneous Intracerebral Hemorrhage Characteristics

Abstract Background and aims Health insurance coverage influences access to acute care and outcomes following spontaneous intracerebral hemorrhage (sICH). It remains unclear whether these disparities reflect differences in disease severity at presentation or hospital course. We aimed to investigate this relationship to better inform targeted strategies for patients with sICH. Methods We retrospectively reviewed adults admitted with sICH between January-December 2020 and October 2024-June 2025 at a Southeastern U.S. tertiary center. Data was extracted from electronic records, and patients were grouped as insured or uninsured. Outcomes included ICH volume, initial systolic blood pressure (SBP), LOS, AKI, and mortality, and were compared using independent t-tests and chi-square analyses. Results Among 147 patients (mean age 63 ± 13 years; 59% male), 68% were insured. Uninsured patients were younger (58 vs 67 years) and more likely to present with higher SBP (median 179 vs 167 mmHg) and brainstem hemorrhage involvement (26% vs 3%). Mean hematoma volume was similar between insured and uninsured groups (14.1 vs 13.7 mL). Uninsured status was associated with non-significant trends toward longer LOS (22 vs 12 days, p = 0.06), higher AKI rates (21% vs 14%, p = 0.25), and higher mortality (26% vs 22%, p = 0.12). Conclusions Preliminary analyses show no statistically significant differences in hematoma volume or in-hospital outcomes by insurance status. However, trends toward greater SBP, hospitalization, and complications among younger and uninsured patients warrant investigation in larger samples. Further data collection will clarify whether insurance status independently predicts features of sICH severity, while assessing differences among specific insurance types. Conflict of interest Priyanka Menon: nothing to disclose, Parth Patel: nothing to disclose, Anthony Elengickal: nothing to disclose, Nicole Tayag: nothing to disclose, Srijita Nandy: nothing to disclose, Kathryn Sinha: nothing to disclose, Manan Shah: nothing to disclose, Bruno Askiel: nothing to disclose, Jonathan Crowe: nothing to disclose, Amir Mbonde: nothing to disclose