To examine the relationship between insurance status and (1) initial severity of spontaneous intracerebral hemorrhage (sICH), as measured by hematoma volume, and (2) in-hospital outcomes, including acute kidney injury (AKI), length of stay (LOS), and mortality. 

Among 147 patients (mean age 63 ± 13 years; 59% male), 68% were insured. Uninsured patients were younger (58 vs 67 years) and more likely to present with higher SBP (median 179 vs 167 mmHg) and brainstem involvement (26% vs 3%). Mean hematoma volume was similar (14.1 vs 13.7 mL). Uninsured status was associated with non-significant trends towards longer LOS (22 vs 12 days, p=0.06), higher rate of AKI (21% vs 14%, p=0.25) and higher mortality (26% vs 22%, p=0.12). 

In our single-center study, preliminary analyses show no statistically significant differences in hematoma volume or in-hospital outcomes by insurance status. However, trends toward higher SBP, longer hospitalization, and greater complication rates among younger and uninsured patients warrant continued investigation in larger samples. Further data collection will clarify whether insurance status independently predicts features of sICH severity and outcomes, while assessing differences among specific insurance types (private, Medicare, Medicaid, VA).