Primary intracerebral hemorrhage in Izumo City, Japan: Incidence rates and outcome in relation to the site of hemorrhage
Primary intracerebral hemorrhage in Izumo City, Japan: Incidence rates and outcome in relation to the site of hemorrhage
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DOI：
10.1227/01.neu.0000093825.04365.f3
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发表时间：
2003-12-01
期刊：
影响因子：
4.8
通讯作者：
Yahara, K
中科院分区：
文献类型：
--
作者：
Inagawa, T;Ohbayashi, N;Yahara, K
目的：这项以社区为基础的研究的目的是调查原发性脑出血（ICH）的发病率和预后与出血部位的关系。方法：研究对象是1991年至1998年在日本出云市接受治疗的350例原发性首次ICH患者。在所有年龄段，所有类型ICH的粗发病率以及年龄和性别调整后的发病率分别为52/100，000和47/100，000。最常见的ICH部位是壳核（120例患者，34%），其次是丘脑（115例，33%）、脑叶区（53例，15%）、脑干（30例，9%）、小脑（25例，7%）和尾状核（7例，2%）。每10万人的粗发病率和年龄、性别校正的年发病率分别为：壳核18和16，丘脑17和15，脑叶8和7，小脑4和3，脑干4和4，尾状核1和1。入院时格拉斯哥昏迷量表评分在小脑出血患者中最好，在脑干出血患者中最差。壳核、丘脑、尾状核、脑叶和小脑的手术率分别为34%、9%、14%、21%和32%，但未对脑干进行手术。30天病死率为壳核11%，丘脑9%，尾状核14%，脑叶11%，小脑0%，脑干损伤53%。当对ICH患者进行整体分析时，30天、3个月和3年的总生存率分别为87%、83%和73%。脑出血后的近期和远期预后均与出血部位和出血严重程度直接相关，出血严重程度通过血肿体积和格拉斯哥昏迷评分进行评估。总体而言，190（54%）的350例患者有一个良好的结果，和55（16%）在出院时死亡。结论：观察到显着差异的发病率和原发性ICH的出血部位有关的结果。结果的差异主要是由于每种ICH亚型出血严重程度的差异。
OBJECTIVE: The aim of this community-based study was to investigate the incidence rates and outcome of primary intracerebral hemorrhage (ICH) in relation to the site of hemorrhage.METHODS: The subjects were 350 patients with primary first-ever ICH who were treated during the 8-year period 1991 to 1998 in Izumo City, Japan.RESULTS: The crude and age- and sex-adjusted incidence rates for all types of ICH were 52 and 47 per 100,000 population, respectively, for all ages. The most common site of ICH was the putamen (120 patients, 34%), followed by the thalamus (115, 33%), lobar areas (53, 15%), brainstem (30, 9%), cerebellum (25, 7%), and caudate nucleus (7, 2%). The crude and age- and sex-adjusted annual incidence rates per 100,000 population were 18 and 16 for putaminal, 17 and 15 for thalamic, 8 and 7 for lobar, 4 and 3 for cerebellar, 4 and 4 for brainstem, and 1 and I for caudate hemorrhages, respectively. The Glasgow Coma Scale scores on admission were best in patients with cerebellar hemorrhage and worst in those with brainstem hemorrhage. Surgery was performed for 34% of putaminal, 9% of thalamic, 14% of caudate, 21% of lobar, and 32% of cerebellar hemorrhages but not for brainstem hemorrhages. The 30-day case fatality rate was 11% for putaminal, 9% for thalamic, 14% for caudate, 11% for lobar, 0% for cerebellar, and 53% for brainstem hemorrhages. When patients with ICH were analyzed as a whole, the overall survival rates at 30 days, 3 months, and 3 years were 87, 83, and 73%, respectively. Both the short-term and long-term outcomes after ICH were directly related to the site of hemorrhage and the severity of bleeding, which was assessed by the hematoma volume and Glasgow Coma Scale score. Overall, 190 (54%) of 350 patients had a favorable outcome, and 55 (16%) had died at discharge.CONCLUSION: Marked differences were observed in the incidence rates and outcome of primary ICH in relation to the site of hemorrhage. The differences in outcome were primarily a result of differences in the severity of bleeding for each ICH subtype.