Abstract WP211: Association of Infection with 3- and 6-Month Outcomes after Intracerebral Hemorrhage

Introduction: Infections, including urinary tract infections (UTI) and pneumonia, affect up to a fourth of patients after an intracerebral hemorrhage (ICH), negatively impacting 3-month functional outcomes independent of hemorrhage severity. However, associations beyond the 3-month period have not been studied. We have leveraged a multi-site, prospective, observational study that enrolled spontaneous ICH patients with 3- and 6-month outcomes to investigate this association. Methods: We identified acute ICH cases from 6 sites across the US between 2017-2024 with and without infection (pneumonia and UTI). Univariate analysis was performed to evaluate the individual association of certain variables (race, sex, comorbidities, and ICH characteristics) with 3- and 6-month outcomes. Multivariate logistic regression analysis using backward elimination methodology was conducted to determine the independent association of variables, including infection, on the 3- and 6-months outcomes. Our primary outcome was dichotomized modified Rankin Scale (mRS) with mRS 0-3 representing good and mRS 4-6 representing poor outcome. Variables with a p<0.1 (race, infection, volume, and location of ICH), along with diabetes, were included in our adjusted analysis. Results: In a univariate analysis of 278 ICH patients, 23 (8%) had pneumonia and 31 (11%) and had UTI. Of the patients with pneumonia and UTI,18 (78%, p < 0.0001) and 20 (65%, p<0.0001) had poor 3-month outcomes, respectively. By 6 months 8 (57%, p<0.05) and 12 (60%, p<0.05) had poor outcomes, respectively. When controlling for race, diabetes, ICH location, ICH volume, and infection, pneumonia independently had a significant association with poor outcomes 3-months post-ICH (p=0.01). At 6-months post-ICH, this association was no longer significant (p=0.12; see Table). Conclusion: This study demonstrates that, in addition to ICH volume and location, pneumonia is associated with poor 3-month outcomes after ICH. This association is attenuated by 6-months post-ICH. This finding may be clinically relevant to overall long-term outcomes in patients with ICH and infection. These conclusions are limited by sample size and future studies with larger sample size may contribute further to these findings.