Risk of traumatic intracranial hemorrhage among patients after a new stroke: A nationwide population-based cohort study in Taiwan

Carlos Shu Kei Lam, Yun-Ting Fang, Chia Chieh Chang, Ping Ling Chen

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Background: Stroke and traumatic intracranial hemorrhage (tICH) are important causes of disability worldwide. The detrimental effect of a stroke may increase the tICH risk. However, this risk has yet to be studied.

Objective: This study evaluated the risk of tICH among patients after a new stroke.

Methods: A population-based retrospective cohort study was conducted using the Taiwanese National Health Insurance Research Database. All patients having a stroke before 2017 were excluded. Patients suffering a new stroke since 2017 were extracted to
compare with those without a new stroke. These two patient groups were followed up from 2017 to 2019, and the occurrence of tICH was considered the outcome parameter. The Cox proportional hazards model was conducted to compare the tICH risk between
these two patient groups.

Results: Data for 164,628 patients with a new stroke were extracted, including 1,004 patients suffering from tICH. Stroke patients had a higher risk of tICH than non-stroke patients (adjusted HR:3.49, 95% CI: 3.17–3.84) and hemorrhage stroke was associated with a higher risk than ischemic stroke (5.64, 4.97–6.39 vs 2.87, 2.58–3.18). Older stroke patients (≥ 45 years old) had a higher risk than younger stroke patients (< 45 years old) (7.89, 6.41–9.70 vs 4.44, 2.99–6.59 respectively). Liver cirrhosis, dementia, and Parkinson's
disease were significant risk factors (1.97, 1.51–2.56; 1.69, 1.44–2.00; and 2.17, 1.71–2.75). The highest incidence density of tICH was noted within nine months after stroke and six months after stroke for patients older than 65 and those injured after a fall.

Conclusions: Stroke patients, especially those ≥ 45 years old, have a significantly higher risk of tICH after head injury. Interventions should be implemented among patients with new strokes in the time windows of the highest tICH incidence density.
Original languageEnglish
Title of host publicationAsia Pacific Stroke Conference 2023
Publication statusPublished - Dec 2023
EventAsia Pacific Stroke Conference 2023: in conjunction with Annual Scientific Meeting 2023 of the Hong Kong Stroke Society - Hong Kong Science and Technology Parks, Hong Kong
Duration: Dec 1 2023Dec 3 2023

Publication series

NameCerebrovascular Diseases
NumberSuppl. 2
ISSN (Print)1015-9770
ISSN (Electronic)1421-9786


ConferenceAsia Pacific Stroke Conference 2023
CityHong Kong
Internet address


  • stroke
  • traumatic intracranial hemorrhage
  • cohort study


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