Impact of chronic liver disease (CLD) on mortality, complications, and early readmission in patients with spontaneous intracranial hemorrhage (ICH): A National Readmission Database Analysis 2016-2020.

Background: Chronic liver disease (CLD) is associated with worse outcomes in many medical conditions, but its impact on patients with spontaneous intracranial hemorrhage (ICH) has not been fully explored. This study aims to evaluate the influence of CLD on in-hospital outcomes of patients with a spontaneous ICH.

Methods: Data from the Nationwide Readmissions Database (NRD) between 2016 and 2020 were retrospectively reviewed. Patients ≥ 18 years old admitted for the first time with a spontaneous ICH were included. Study outcomes included in-hospital mortality, length of stay (LOS), major complications, and 90-day readmission rate. Patients with and without CLD were matched using 1:4 propensity score matching (PSM). Univariate and multivariable logistic and linear regression analyses were performed to determine the associations between CLD and outcomes of interest.

Results: After applying PSM, 21,345 patients were included in the analysis of which 4,269 had CLD. After adjustment, compared to patients without CLD, those with CLD had significantly higher in-hospital mortality (adjusted odds ratio [aOR] = 1.23, 95% confidence interval [CI]: 1.13-1.34, p < 0.001), a longer LOS(aOR = 1.26, 95% CI: 1.12-1.39, p < 0.001), higher rates of major complications(aOR = 1.76, 95% CI: 1.62-1.91, p < 0.001), and increased 90-day readmission rates (aOR = 1.20, 95% CI: 1.09-1.31, p < 0.001)​.

Conclusions: CLD is independently associated with higher mortality, more complications, longer LOS, and higher readmission rates in patients admitted for spontaneous ICH. These findings underscore the need for specialized care strategies for patients with an ICH and underlying CLD.