Abstract WP477: ICH in a Mid-South Mobile Stroke Unit Sample: Demographics, Clinical Findings, and Geospatial Distribution

Abstract

Background: Clinical and geospatial differences in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) patients within stroke belt region mobile stroke units (MSU) have not been described. We sought to understand presentation differences in the Mid-South. Methods: Consecutive MSU patients were analyzed for demographic, call, and clinical characteristics. Cases were geocoded, spatially joined to zip code shapefile with raw counts normalized to population; incidence rates were calculated and symbolized by mathematical natural breaks. Results: 292 AIS and 29 ICHs were transported in 52 weeks; age was similar (ICH 63 + 15 vs. AIS 64 + 15), cases were mostly female (ICH 64%; AIS 60%), with African Americans (AA) significantly more likely to have AIS (74%) compared to ICH (64%; p=0.023). Median ICH NIHSS was significantly higher (median 9.5, IQR 5.5-17) then AIS NIHSS (median 5, IQR 2-9; p<0.001), as were SBP (ICH 184 + 37mmHg vs. AIS 159 + 35mmHg; p<0.001) and DBP (ICH 104 + 21mmHg vs. AIS 91 + 21mmHg; p=0.003). ICH patients were significantly more likely to be treated within the first 60 minutes of symptom onset (p<0.001) then AIS. High incidence ICH territories were geospatially defined. Conclusions: Mid-South ICH MSU patients have surprisingly different demographics than National data, and were most commonly female, but less likely to be of AA. A discreet geospatial ICH pattern was identified for high ICH risk.