Abstract Number: Esoc2026a859 Incidence, Treatment Metrics and Outcomes of Intracerebral Hemorrhage in Hong Kong: A 10-Year Territory-Wide Study

Abstract Background and aims Characterizing temporal trends in spontaneous intracerebral haemorrhage (ICH) care identifies priority areas for clinical improvement, establishes baseline key-performance-metrics for longitudinal evaluation, and supports evidence-informed allocation of healthcare resources. We aimed to determine the temporal trends in incidence, treatment metrics and outcomes of ICH in Hong Kong. Methods A retrospective cohort study was conducted utilizing the territory-wide electronic database from the Hong Kong Hospital Authority. Temporal trends in crude incidence, age-standardised incidence, mortality, case fatality rate, ED-to-CT interval, ED-to-ward-admission interval, proportion of patients achieving SBP ≤ 140 mmHg, and CTA utilisation from 2014 to 2024 were analysed using Joinpoint regression. Results We identified 25,448 ICH patients within the study period. Age-standardised incidence decreased by 0.592 per 100,000 person-years (95%CI 0.292ー0.892, P = 0.002). Age-standardised mortality declined significantly by 0.27 deaths per 100,000 person-years (95%CI 0.186ー0.359, P 0.001). 30-days-case fatality was static across all subgroups (Age 20-39, 40-59, 60-79, 80+, range 11.4-18.1%; 15.7-17.8%; 22.4-26.2%; 37.8-42.1%, respectively). Median ED-to-CT and median ED-to-ward-admission time range were 26-39minutes and 68-92minutes, respectively. More ICH patients achieved a SBP of ≤140mmHg on ward admission (from 17.5% to 22.8%, P = 0.017). CTA utilisation remained low (range 0.9%ー3.7%, P = 0.055). Conclusions Age-standardised incidence and mortality of ICH have declined in Hong Kong. Yet, the persistently high case fatality rate highlights inadequacies in ICH care, particularly the low proportion of patients achieving early intensive SBP control. These findings underscore necessity for implementation of territory-wide multidisciplinary ICH care pathways. Conflict of interest Bianca Chan: nothing to disclose. Bella Wong: nothing to disclose. Sing Yau Li: nothing to disclose. Trista Hung: nothing to disclose. Bonaventure Ip: nothing to disclose. Thomas Leung: nothing to disclose.