Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage

Jolink, Wilmar M.T.; Klijn, Catharina J.M.; Brouwers, P. J. A. M.; Kappelle, L. Jaap; Vaartjes, Ilonca

doi:10.1212/wnl.0000000000002015

Cited by 119 publications

(101 citation statements)

References 28 publications

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“…The 48% reduction in the incidence rate of PICH was close to the reduction of over 50% that was found in Oxfordshire, UK . The reported decrease in PICH incidence was evident in both sexes and in all age groups and was remarkable in subjects aged less than 75 years, as observed in other studies . The decrease probably depends on more effective control of risk factors, especially arterial hypertension, and improved diagnosis of secondary ICH.…”

Section: Discussionsupporting

confidence: 84%

Declining incidence of intracerebral hemorrhage over two decades in a population‐based study

Sacco

Ornello

Degan

et al. 2016

Euro J of Neurology

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Section: Discussionsupporting

confidence: 84%

Declining incidence of intracerebral hemorrhage over two decades in a population‐based study

Sacco

Ornello

Degan

et al. 2016

Euro J of Neurology

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“…Increasing age is also associated with increased morbidity and elderly population above 70 years had a high mortality rate (46.1%) in our series. Several authors have shown that older adults with acute ICH experienced the worse outcomes compared with their younger counterparts, including death, dependency, and overall quality of life [5,[24][25][26].…”

Section: Intraventricular Extension Intraventricular Extensionmentioning

confidence: 99%

Clinical Profile and Predictors of Outcome in Spontaneous Intracerebral Hemorrhage from a Tertiary Care Centre in South India

Hegde

Menon

Kumar

et al. 2020

Stroke Research and Treatment

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Background. This article attempts to evaluate the clinical profile and outcome determinants following hypertensive SICH in a South Indian population. The study represents the largest series of SICH reported from a single centre in India. Materials and Methods. Prospective data collection and analysis of patients with SICH admitted to our centre between 1st January 2015 and 31st December 2018. The variables analysed include: age, sex, comorbidities, Glasgow coma score (GCS) on admission, radiological features, treatment modality, and outcome at three months. Modified Rankin score (mRS) was used to assess the outcome at discharge and three months. Results. Our study group of 905 patients included 638 males and 267 females and the mean age at presentation was 58.10 ± 12.76 years. The study group included 523 patients (57.8%) previously diagnosed hypertensive, of whom 36.3% (n=190) were on irregular medication. The most frequent locations of hematoma were basal ganglia (478), thalamus (202), lobar (106), cerebellar (61), brainstem (31), and primary intraventricular haemorrhage (27). Secondary intraventricular extension was seen in 425 (47%) patients on admission. The mean volume of the clot on admission was 23.45 ± 19.79 ml, and clot progression was seen in only 46 (5.08%) cases. Surgical evacuation through craniotomy was done in 147 (16.8%) patients, and external ventricular drainage (EVD) was placed in 56 (6.2%) patients. Overall 3−month mortality was 30.1% (266 patients). On the last follow up a favorable outcome (mRS 0−3) was observed in 412 (45.53%) patients and a poor outcome (mRS 4−5) in 207 patients (22.87%). Independent predictors of mortality are Age >70 (p=<0.001, OR 4.806, 95% CI 3.064–7.54), admission GCS <8 (p=<0.001, OR7.684, 95% CI 5.055#x2013;11.68), and Hematoma volume >30 ml (p=<0.001, OR 2.45, 95% CI 1.626–3.691). Intraventricular haemorrhage was an additional poor outcome predictor (p<0.015, CI 1.105–2.585). Surgical evacuation reduced mortality in the group, but morbidity rates remained the same. Conclusions. SICH predominantly affects a younger population in India in comparison to the Western society. Elderly age, poor GCS on admission, clot volume above 30 ml and intraventricular extension remain the most consistent predictors of death and poor outcome. Further studies are needed to assess the risk of SICH among hypertensive patients and to prognosticate the outcome after SICH using novel predictors, including biomarkers.

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“…14,16,17 ICD-9 and ICD-10 codes for the identification of stroke have been proven to be reliable in studies of patients with stroke of all ages. 18,19 For this study, we specifically assessed the accuracy of ICD-10 codes for young adults (aged 18-49 years). We checked final diagnoses in medical records against the attached ICD-10 code at discharge of 569 patients admitted in 2 university medical centers and 1 large general hospital between 1995 and 2017.…”

Section: Exposurementioning

confidence: 99%

Association of Stroke Among Adults Aged 18 to 49 Years With Long-term Mortality

Ekker¹,

Verhoeven²,

Vaartjes

et al. 2019

JAMA

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IMPORTANCE Stroke remains the second leading cause of death worldwide. Approximately 10% to 15% of all strokes occur in young adults. Information on prognosis and mortality specifically in young adults is limited. OBJECTIVE To determine short-and long-term mortality risk after stroke in young adults, according to age, sex, and stroke subtype; time trends in mortality; and causes of death. DESIGN, SETTING, AND PARTICIPANTS Registry-and population-based study in the Netherlands of 15 527 patients aged 18 to 49 years with first stroke between 1998 and 2010, and follow-up until January 1, 2017. Patients and outcomes were identified through linkage of the national Hospital Discharge Registry, national Cause of Death Registry, and the Dutch Population Register. EXPOSURES First stroke occurring at age 18 to 49 years, documented using International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes for ischemic stroke, intracerebral hemorrhage, and stroke not otherwise specified. MAIN OUTCOMES AND MEASURES Primary outcome was all-cause cumulative mortality in 30-day survivors at end of follow-up, stratified by age, sex, and stroke subtype, and compared with all-cause cumulative mortality in the general population. RESULTS The study population included 15 527 patients with stroke (median age, 44 years [interquartile range, 38-47 years]; 53.3% women). At end of follow-up, a total of 3540 cumulative deaths had occurred, including 1776 deaths within 30 days after stroke and 1764 deaths (23.2%) during a median duration of follow-up of 9.3 years (interquartile range, 5.9-13.1 years). The 15-year mortality in 30-day survivors was 17.0% (95% CI, 16.2%-17.9%). The standardized mortality rate compared with the general population was 5.1 (95% CI, 4.7-5.4) for ischemic stroke (observed mortality rate 12.0/1000 person-years [95% CI, 11.2-12.9/1000 person-years]; expected rate, 2.4/1000 person-years; excess rate, 9.6/1000 person-years) and the standardized mortality rate for intracerebral hemorrhage was 8.4 (95% CI, 7.4-9.3; observed rate, 18.7/1000 person-years [95% CI, 16.7-21.0/1000 person-years]; expected rate, 2.2/1000 person-years; excess rate, 16.4/1000 person-years). CONCLUSIONS AND RELEVANCE Among young adults aged 18 to 49 years in the Netherlands who were 30-day survivors of first stroke, mortality risk compared with the general population remained elevated up to 15 years later.

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Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage

Cited by 119 publications

References 28 publications

Declining incidence of intracerebral hemorrhage over two decades in a population‐based study

Declining incidence of intracerebral hemorrhage over two decades in a population‐based study

Clinical Profile and Predictors of Outcome in Spontaneous Intracerebral Hemorrhage from a Tertiary Care Centre in South India

Association of Stroke Among Adults Aged 18 to 49 Years With Long-term Mortality

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