Adjusted Morbidity Groups and Intracerebral Haemorrhage: A Retrospective Primary Care Cohort Study

Blanca Lorman-Carbó, Josep Lluis Clua-Espuny, Eulalia Muria-Subirats, Juan Ballesta-Ors, Maria Antònia González-Henares, Meritxell Pallejà-Millán and Francisco M. Martín-Luján
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Blanca Lorman-Carbó: Primary Health-Care Centre, Institut Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43500 Tortosa, Spain
Josep Lluis Clua-Espuny: Primary Health-Care Centre, Institut Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43500 Tortosa, Spain
Eulalia Muria-Subirats: Primary Health-Care Centre, Institut Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43500 Tortosa, Spain
Juan Ballesta-Ors: Primary Health-Care Centre, Institut Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43500 Tortosa, Spain
Maria Antònia González-Henares: Primary Health-Care Centre, Institut Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43500 Tortosa, Spain
Meritxell Pallejà-Millán: Research Support Unit Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), 43202 Reus, Spain
Francisco M. Martín-Luján: Biomedicine Doctoral Programme, University Rovira i Virgili, 43201 Reus, Spain

IJERPH, 2021, vol. 18, issue 24, 1-15

Abstract: Background: Intracerebral haemorrhage rates are increasing among highly complex, elderly patients. The main objective of this study was to identify modifiable risk factors of intracerebral haemorrhage. Methods: Multicentre, retrospective, community-based cohort study was conducted, including patients in the Adjusted Morbidity Group 4 with no history of intracerebral haemorrhage. Cases were obtained from electronic clinical records of the Catalan Institute of Health and were followed up for five years. The primary outcome was the occurrence of intracerebral haemorrhage during the study period. Demographic, clinical and pharmacological variables were included. Logistic regression analyses were carried out to detect prognostic variables for intracerebral haemorrhage. Results: 4686 subjects were included; 170 (3.6%) suffered an intracerebral haemorrhage (85.8/10,000 person–year [95% CI 85.4 to 86.2]). The HAS-BLED score for intracerebral haemorrhage risk detection obtained the best AUC (0.7) when used in the highest complexity level (cut-off point ≥3). Associated independent risk factors were age ≥80 years, high complexity and use of antiplatelet agents. Conclusions: The Adjusted Morbidity Group 4 is associated with a high risk of intracerebral haemorrhage, particularly for highly complex patients and the use of antiplatelet agents. The risk of bleeding in these patients must be closely monitored.

Keywords: cerebral haemorrhage; chronicity; multimorbidity; primary health care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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