Contemporary Trends in the Nationwide Incidence of Primary Intracerebral Hemorrhage

Abdulaziz T. Bako, Alan Pan, Thomas Potter, Jonika Tannous, Carnayla Johnson, Eman Baig, Jennifer Meeks, Daniel Woo, Farhaan S. Vahidy

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background: We report contemporary trends in nationwide incidence of intracerebral hemorrhage (ICH) across demographic and regional strata over a 15-year period. Methods: Utilizing the Nationwide Inpatient Sample (2004-2018) and US Census Bureau data, we calculated ICH incidence rates for age, race/ethnicity, sex, and hospital region sub-cohorts across 5 consecutive 3-year periods (2004-2006 to 2016-2018). We fit Poisson and log binomial regression models to evaluate demographic and regional differences in ICH incidence and trends in prevalence of hypertension and past/current anticoagulant use among hospitalized ICH patients. Results: Overall, the annual incidence rate (95% CI) of ICH per 100 000 was 23.15 (23.10-23.20). The 3-year incidence of ICH (per 100 000) increased from 62.79 in 2004 to 2006 to 78.86 in 2016 to 2018 (adjusted incidence rate ratio, CI: 1.11 [1.02-1.20]), coinciding with increased 3-year prevalence of hypertension and anticoagulant use among hospitalized ICH patients (adjusted risk ratio, CI: hypertension - 1.16 [1.15-1.17]; anticoagulant use - 2.30 [2.14-2.47]). We found a significant age-time interaction, whereby ICH incidence increased significantly faster among those aged 18 to 44 years (adjusted incidence rate ratio, CI: 1.10 [1.05-1.14]) and 45 to 64 years (adjusted incidence rate ratio, CI: 1.08 [1.03-1.13]), relative to those aged ≥75 years. Conclusions: Rising ICH incidence among young and middle-aged Americans warrants ICH prevention strategies targeting these economically productive age groups.

Original languageEnglish (US)
Pages (from-to)E70-E74
Issue number3
StatePublished - Mar 1 2022


  • anticoagulant
  • cerebral hemorrhage
  • hospital
  • hypertension
  • incidence
  • prevalence
  • stroke
  • Prevalence
  • Humans
  • Middle Aged
  • Hypertension/epidemiology
  • Male
  • Cerebral Hemorrhage/epidemiology
  • Incidence
  • Young Adult
  • United States/epidemiology
  • Adolescent
  • Aged, 80 and over
  • Adult
  • Female
  • Aged
  • Odds Ratio

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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