Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage
Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage
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DOI：
10.1212/wnl.0000000000002015
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发表时间：
2015-10-13
期刊：
影响因子：
9.9
通讯作者：
Vaartjes, Ilonca
中科院分区：
文献类型：
--
作者：
Jolink, Wilmar M. T.;Klijn, Catharina J. M.;Vaartjes, Ilonca
目的：评估荷兰脑出血（ICH）发病率和30天和1年病死率的年龄和性别特异性趋势。方法：通过国家医院出院登记处和人口登记处的链接，使用ICD-9代码431识别因首次ICH住院的患者。我们在国家死亡原因登记册中确定了院外死亡。按年龄和性别计算发病率、30天和1年病死率以及总死亡率。我们通过联合点回归分析和Mann-Kendall检验确定了时间趋势。结果：我们在1998年至2010年期间确定了41，068例ICH病例（51%为男性），其中6%为院外死亡。75岁以下男性和女性的ICH发生率下降（p 0.01，35-54岁男性无显著性），但75岁及以上患者的ICH发生率保持稳定。年龄小于75岁的患者30天和1年病死率下降（35-54岁女性无显著性）。在35至54岁的患者中，ICH死亡率在2003年之前保持稳定，然后略有下降（年百分比变化[APC]男性：-7. 09%; 95%置信区间[CI]-11. 39至-2. 59;女性：-8. 67%; 95% CI-15. 18至-1. 66）。在55至74岁的患者中，1995年至2010年期间男性（APC-4. 55%; 95% CI-5. 49至-3. 59）和1992年至2010年期间女性（APC-3. 51%; 95% CI-4. 16至-2. 85）的死亡率下降。死亡率并没有下降，在75岁及以上的患者。结论：在荷兰，ICH的发病率，病死率和死亡率显着下降，男性和女性年龄小于75岁，但保持稳定的患者75岁及以上。观察到的时间趋势可能是由于在过去20年中老年人似乎没有受益的更好的预防和治疗。
Objective:To assess age- and sex-specific trends in incidence and 30-day and 1-year case fatality of intracerebral hemorrhage (ICH) in the Netherlands.Methods:Patients hospitalized for first ICH were identified through linkage of the national hospital discharge register and population register using ICD-9 code 431. We identified out-of-hospital deaths in the national cause of death register. Incidence, 30-day and 1-year case fatality, and total mortality rate were calculated by age and sex. We identified time trends by joinpoint regression analysis and Mann-Kendall tests.Results:We identified 41,068 cases of ICH (51% men) between 1998 and 2010, of which 6% were out-of-hospital deaths. ICH incidence declined in men and women younger than 75 years (p 0.01, not significantly in men 35-54 years) but remained stable in patients 75 years and older. Thirty-day and 1-year case fatality declined in patients younger than 75 years (not significantly in women 35-54 years). In patients aged 35 to 54 years, ICH mortality remained stable until 2003 and then declined slightly (annual percentage change [APC] men: -7.09%; 95% confidence interval [CI] -11.39 to -2.59; women: -8.67%; 95% CI -15.18 to -1.66). In patients 55 to 74 years, mortality declined in men between 1995 and 2010 (APC -4.55%; 95% CI -5.49 to -3.59) and in women between 1992 and 2010 (APC -3.51%; 95% CI -4.16 to -2.85). Mortality did not decline in patients aged 75 years and older.Conclusion:In the Netherlands, ICH incidence, case fatality, and mortality rates have declined significantly in men and women younger than 75 years but remained stable in patients 75 years and older. The observed time trends may be explained by better prevention and treatment during the previous 2 decades of which the elderly do not seem to benefit.