Contemporary Trends in the Nationwide Incidence of Primary Intracerebral Hemorrhage

Abstract

Background: We report contemporary trends in nationwide incidence of intracerebral hemorrhage (ICH) across demographic and regional strata over a 15-year period. Methods: Utilizing the Nationwide Inpatient Sample (2004–2018) and US Census Bureau data, we calculated ICH incidence rates for age, race/ethnicity, sex, and hospital region sub-cohorts across 5 consecutive 3-year periods (2004–2006 to 2016–2018). We fit Poisson and log binomial regression models to evaluate demographic and regional differences in ICH incidence and trends in prevalence of hypertension and past/current anticoagulant use among hospitalized ICH patients. Results: Overall, the annual incidence rate (95% CI) of ICH per 100 000 was 23.15 (23.10–23.20). The 3-year incidence of ICH (per 100 000) increased from 62.79 in 2004 to 2006 to 78.86 in 2016 to 2018 (adjusted incidence rate ratio, CI: 1.11 [1.02–1.20]), coinciding with increased 3-year prevalence of hypertension and anticoagulant use among hospitalized ICH patients (adjusted risk ratio, CI: hypertension—1.16 [1.15–1.17]; anticoagulant use—2.30 [2.14–2.47]). We found a significant age-time interaction, whereby ICH incidence increased significantly faster among those aged 18 to 44 years (adjusted incidence rate ratio, CI: 1.10 [1.05–1.14]) and 45 to 64 years (adjusted incidence rate ratio, CI: 1.08 [1.03–1.13]), relative to those aged ≥75 years. Conclusions: Rising ICH incidence among young and middle-aged Americans warrants ICH prevention strategies targeting these economically productive age groups.

Neuroprotective Role of α-Lipoic Acid in Iron-Overload-Mediated Toxicity and Inflammation in In Vitro and In Vivo Models

“…Intracerebral hemorrhage (ICH) represents a leading cause of morbidity and mortality in the world, frequently associated with severe long-term disability in surviving patients [ 1 ]. ICH is the most common hemorrhagic stroke subtype, with an estimated incidence rate per year of 23.15 per 100,000 worldwide, with higher incidence in males [ 2 ]. Spontaneous and non-traumatic ICH is usually due to an underlying lesion, although most of the cases in the adult population are attributable to hypertension, which represents the most common systemic risk factor, reported in up to 70% of ICH patients [ 3 ].…”

T-Lymphocyte Interactions with the Neurovascular Unit: Implications in Intracerebral Hemorrhage

“…ICH causes catastrophic brain damage and particularly poor prognoses in patients. In spite of improvements in control and prevention of risk factors, nationwide ICH incidence has increased in the past 15 years and minority populations continue to experience disparate ICH burden [1]. Higher rates of increase in ICH incidence among young and middle-aged Americans are particularly concerning and warrant continued research endeavors.…”

“…Higher rates of increase in ICH incidence among young and middle-aged Americans are particularly concerning and warrant continued research endeavors. In 2020 the global incidence of ICH was 3.41 million with substantial corresponding global deaths [1,2]. Despite this ongoing and growing public health burden, the standard approach to treatment remains restricted to symptomatic control [3,4].…”

Trends in the Incidence of Spontaneous Subarachnoid Hemorrhages in the United States, 2007–2017

“…2 The demographic characteristics of patients with stroke in the United States are changing. Increasingly more adults are being diagnosed with acute ischemic stroke and intracerebral hemorrhage at younger ages, 6,7 but how SAH incidence has changed over time in various age and sex groups remains unknown.…”