THE RISK OF SUBARACHNOID AND INTRACEREBRAL HEMORRHAGES IN BLACKS AS COMPARED WITH WHITES
THE RISK OF SUBARACHNOID AND INTRACEREBRAL HEMORRHAGES IN BLACKS AS COMPARED WITH WHITES
复制标题
DOI：
10.1056/nejm199203123261103
复制
发表时间：
1992-03-12
影响因子：
158.5
通讯作者：
MILLER, R
中科院分区：
文献类型：
--
作者：
BRODERICK, JP;BROTT, T;MILLER, R
背景中风是黑人死亡的一个重要原因，脑内和蛛网膜下腔出血占所有中风早期死亡的近一半。本研究调查黑人和白人患脑内或蛛网膜下腔出血的风险是否不同。我们回顾了1988年大辛辛那提都市区近130万人中所有疑似脑内或蛛网膜下腔出血患者的病历、尸检报告和CT扫描。在1，086，462名白人中有221例首次自发性颅内出血（159例脑内出血和62例蛛网膜下腔出血），在171，718名黑人中有45例（27例脑内出血和18例蛛网膜下腔出血）。黑人的蛛网膜下腔出血风险是白人的2.1倍（95%置信区间，1.3至3.6），脑内出血风险是白人的1.4倍（95%置信区间，0.9至2.1）。在75岁以下的人群中，黑人脑出血的风险是白人的2.3倍（95%置信区间，1.5 - 3.6），而75岁或以上的黑人的风险是白人的四分之一（95%置信区间，0.1 - 0.8）。脑内或蛛网膜下腔出血30天内的死亡占每1000名65岁以下黑人的1.9年寿命损失，而每1000名白人为0.5年。青年和中年黑人患蛛网膜下腔或脑内出血的风险明显高于同龄白人。这些类型的中风是年轻和中年黑人死亡率过高的重要原因。
Background. Stroke is an important cause of death among blacks, and intracerebral and subarachnoid hemorrhages account for nearly half of all early deaths from stroke. The present study investigates whether blacks and whites differ in their risk of having either intracerebral or subarachnoid hemorrhage.Methods. We reviewed the medical records, autopsy reports, and CT scans of all patients suspected of having had an intracerebral or subarachnoid hemorrhage during 1988 among the nearly 1.3 million people in the Greater Cincinnati metropolitan area.Results. There were 221 cases of first spontaneous intracranial hemorrhage among 1,086,462 whites (159 intracerebral and 62 subarachnoid hemorrhages), and 45 cases among 171,718 blacks (27 intracerebral and 18 subarachnoid hemorrhages). Blacks had 2.1 times the risk of subarachnoid hemorrhage of whites (95 percent confidence interval, 1.3 to 3.6) and 1.4 times the risk of intracerebral hemorrhage (95 percent confidence interval, 0.9 to 2.1). In those under the age of 75, the risk of intracerebral hemorrhage among blacks was 2.3 times that of whites (95 percent confidence interval, 1.5 to 3.6), whereas the risk among blacks 75 or older was one fourth that of whites (95 percent confidence interval, 0.1 to 0.8). Deaths within 30 days of intracerebral or subarachnoid hemorrhage accounted for 1.9 years of life lost per 1000 blacks under 65 years of age, as compared with 0.5 year per 1000 whites.Conclusions. Young and middle-aged blacks have a substantially higher risk of subarachnoid or intracerebral hemorrhage than whites of similar age. These types of stroke are important causes of excess mortality among young and middle-aged blacks.