Intracerebral haemorrhage in a population-based stroke registry (LuSSt): incidence, aetiology, functional outcome and mortality
Intracerebral haemorrhage in a population-based stroke registry (LuSSt): incidence, aetiology, functional outcome and mortality
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DOI：
10.1007/s00415-013-7013-0
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发表时间：
2013-10-01
影响因子：
6
通讯作者：
Grau, A. J.
中科院分区：
文献类型：
--
作者：
Palm, F.;Henschke, N.;Grau, A. J.
关于脑出血（ICH）发生率的数据差异很大。基于人群的ICH生存率和功能结局预测因素的数据很少。路德维希港卒中研究是一项前瞻性、基于人群的卒中登记研究，始于2006年1月。德国路德维希港市所有患有急性中风或短暂性脑缺血发作的居民都要登记。本分析纳入了2006年至2010年间首次发生原发性脑出血（FE-pICH）的患者。2006年1月1日至2010年12月31日期间，152例患者发生FE-pICH。FE-pICH的粗发病率和年龄校正的发病率/100，000分别为18.7（95%CI 15.9-21.9）和11.9（95%CI 10.2-14.0），并随时间保持稳定。在第28、90和365天，FE-pICH的病死率分别为27.0%、34.9%和44.1%。在21例患者中，记录了（21.3%）早期不复苏命令。从多变量分析中排除这些患者，美国国立卫生研究院卒中量表（NIHSS）（OR 1.22，95% CI 1.08-1.36），高胆固醇血症（OR 0.16，95% CI 0.05-0.55）和改良兰金量表（mRS）（OR 1.56，95%CI 1.06-2.3）与1年死亡率风险独立相关，而NIHSS（OR 1.41，95% CI 1.20-1.66）和入院时白细胞计数（OR 1.48，95% CI 1.16-1.89）与1年后良好或中度功能结局（mRS a千分之三货币符号3）独立相关。FE-ICH的发生率在其他登记研究报告的较低范围内，并在观察期内保持稳定。高血压治疗率的提高可能是部分原因。NIHSS显示的卒中严重程度与1年后的死亡率和功能结局独立相关。我们发现ICH患者的病因和结局之间无相关性。
Data on incidence of intracerebral haemorrhage (ICH) vary widely. Population-based data on predictors of ICH survival and functional outcome are rare. The Ludwigshafen Stroke Study is a prospective, population-based stroke registry which started in January 2006. All residents of the city of Ludwigshafen, Germany, who suffer from acute stroke or transient ischaemic attack are registered. Patients with first-ever primary intracerebral haemorrhage (FE-pICH) between 2006 and 2010 were included in the present analysis. Between January 1st, 2006 and December 31st, 2010, 152 patients suffered a FE-pICH. Crude and age-adjusted incidence rates per 100,000 for FE-pICH were 18.7 (95 % CI 15.9-21.9) and 11.9 (95 % CI 10.2-14.0), respectively, and remained stable over time. Case-fatality rates for FE-pICH were 27.0, 34.9 and 44.1 % at days 28, 90 and 365, respectively. In 21 patients, an (21.3 %) early do-not resuscitate-order was documented. Excluding these patients from multivariate analyses, National Institute of Health Stroke Scale (NIHSS) (OR 1.22, 95 % CI 1.08-1.36), hypercholesterolemia (OR 0.16, 95 % CI 0.05-0.55) and modified Rankin Scale (mRS) prior to stroke (OR 1.56, 95 % CI 1.06-2.3) were independently associated with risk of 1-year mortality, whereas NIHSS (OR 1.41, 95 % CI 1.20-1.66) and leukocyte count on admission (OR 1.48, 95 % CI 1.16-1.89) were independently associated with good or moderate functional outcome (mRS a parts per thousand currency sign 3) after 1 year. Incidence of FE-ICH is in the lower range of those reported from other registries and remained stable over the observation period. Higher treatment rates for hypertension might partly account for this. Stroke severity as indicated by NIHSS was independently associated with mortality and functional outcome after 1 year. We found no association between aetiology and outcome in ICH patients.