Abstract Body: Introduction:
Stroke patients experience higher levels of social isolation (SI) compared to their age matched healthy cohorts which is associated with poor quality of life and increased morbidity and mortality. However, frequency and associates of SI among patients with intracerebral hemorrhage (ICH) have not been described.
Methods:
Data for adult (>18 years) primary non-traumatic ICH patients with prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) measures and modified Rankin scores (mRS) on 1-year follow up were extracted from a stroke outcomes registry for a 7-hospital stroke certified healthcare system. Socioeconomic deprivation was measured using the state-level Area Deprivation Index (ADI; high deprivation defined as ADI > 7). Comorbidity burden was graded by Charlson Comorbidity Index (CCI). The PROMIS short form v2.0 social isolation 4a score was used to assess SI, with SI considered positive at T-scores above 54.9 and further categorized into mild (55-60) and moderate-severe (≥60). Patients with mRS ≥ 3 were considered functionally dependent. Descriptive statistics are provided as proportions (%) and medians with interquartile ranges (IQR). Demographic and comorbidity differences were assessed using chi-squared and Mann-Whitney U tests.
Results:
The cohort included 110 ICH patients (age median [IQR]: 60 [47-71], 43.6% female), of whom 20% were Hispanic and had a racial distribution of 59.0% White, 27.2% Black, 8.2% Asian, 5.5% other (Table 1). Overall, 24 (21.8%) patients experienced some degree of social isolation (54.2% mild, and 45.8% moderate-severe). Among patients with 1-year SI, 33.3% were initially discharged home, 33.3% to rehab, 16.7% to long-term acute care (LTAC), 12.5% to skilled-nursing facility, and 4.2% other. SI patients had higher comorbidity burden (vs non-isolation group; 95.8% vs. 68.6%, p=0.025), higher rates of functional dependence (70.8% vs. 30.8%, p=0.001), and higher rates of diabetes (33.3% vs 12.8%, p=0.040). Finally, patients with moderate-severe SI showed a significantly greater proportion of high socioeconomic deprivation (vs mild; 54.5% vs 7.7%, p=0.039) (Table 2).
Conclusion:
More than 1 in 5 ICH patients may experience long-term SI particularly those with higher comorbidity burden. Furthermore, long-term dependency is associated with higher likelihood of SI among ICH patients. .SI risk stratification for ICH patients is a critical gap in improving post-ICH outcomes.