Abstract Details

Title Emotional and Behavioral Dyscontrol Is More Likely After Intracerebral Hemorrhage than Subarachnoid Hemorrhage

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P6 - Poster Session 6 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-002

Background EBD can be distressful to patients and family and may complicate hospitalization and rehabilitation.

Objective Determine factors associated with emotional and behavioral dyscontrol (EBD) after hemorrhagic stroke.

Design/Methods We prospectively identified patients from 1/2015-2/2021 with non-traumatic hemorrhagic stroke – intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH) – and EBD assessed via telephone at 3-months and 12-months using the Quality of Life in Neurological Disorders EBD Inventory. We examined the relationship between EBD (T-score >50) at 3-months and bleed characteristics, pre-hospitalization social and neuropsychiatric history, neurological/systemic illness severity, and hospital complications. We then compared EBD at 3-months and 12-months.

Results 72 patients completed the 3-month call; 15 (21%) had EBD. At 3-months, EBD was more common in patients with ICH than SAH (14/46 (30% vs. 1/26 (3.8%), p=0.007)) and was associated with lower admission GCS score (13 (IQR 9-15) vs. 15 (IQR 14-15), p=0.009), and higher APACHE II score (17 (IQR 10-18) vs. 11 (IQR 8.5-15.5), p=0.038). Multivariate analysis including bleed type, GCS score, APACHE II score, and neuropsychiatric history, found ICH had a significant relationship with EBD at 3-months (OR 9.6 (95% CI 1.12-83.33, p=0.039). There was no significant relationship between EBD at 3-months and ICH laterality/location/volume, age, sex, race, ethnicity, handedness, education, pre-admission employment, neuropsychiatric/dementia history, tobacco-use, premorbid mRS-score, ventilator-days, infection, or hospital length-of-stay. There were 32 (44%) patients who completed the 12-month follow-up call. There was no agreement (κ=0.083) between EBD at 3-months and 12-months; 19 (59%) patients had no EBD, 2 (6%) had EBD at both timepoints, 9 (28%) only had EBD at 3-months, and 1 (3%) developed EBD at 12-months.

Conclusions Compared to patients with SAH, patients with ICH appear more likely to experience emotional and behavioral dyscontrol 3-months post-stroke, especially with higher ICH severity. These findings help identify patients who may benefit from early neuropsychiatric interventions following hemorrhagic stroke.

Authors/Disclosures
Daniel Talmasov, MD (Columbia University Medical Center) PRESENTER	Dr. Talmasov has nothing to disclose.
	No disclosure on file
Anlys Olivera, MD, PhD (NYU Langone Medical Center)	Dr. Olivera has nothing to disclose.
Aaron Lord, MD (NYU Langone-Brooklyn)	Dr. Lord has nothing to disclose.
Lindsey Gurin, MD (Langone Orthopedic Hospital)	Dr. Gurin has received personal compensation in the range of $0-$499 for serving as a physician reviewer with Healthcare Quality Strategies, Inc. Dr. Gurin has received personal compensation in the range of $500-$4,999 for serving as a consultant with Human Services Research Institute.
Koto Ishida, MD, FAAN (NYU)	Dr. Ishida has received publishing royalties from a publication relating to health care.
Kara R. Melmed, MD	Dr. Melmed has nothing to disclose.
Jose L. Torres, MD (NYU)	Dr. Torres has nothing to disclose.
Barry M. Czeisler, MD, MS, MHPE, FAAN (Providence Specialty Medical Group)	Dr. Czeisler has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for NeuroStat Consulting LLC. Dr. Czeisler has stock in Brainspace.
Cen Zhang, MD	Dr. Zhang has nothing to disclose.
Jennifer A. Frontera, MD (NYU Langone Health)	Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving as a Consultant for FirstKindMedical. Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Physician Education Resource. The institution of Dr. Frontera has received research support from NIH. The institution of Dr. Frontera has received research support from Alexion. Dr. Frontera has received publishing royalties from a publication relating to health care.
Ariane Lewis, MD, FAAN (NYU Langone Medical Center)	Dr. Lewis has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Seminars in Neurology. Dr. Lewis has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neuroscience.