Declining incidence of intracerebral hemorrhage over two decades in a population‐based study. (25th July 2016)

• Record Type: Journal Article
• Authors: Sacco, S.; Ornello, R.; Degan, D.; Tiseo, C.; Pistoia, F.; Carolei, A.
• Is Part Of: European journal of neurology. Volume 23:Number 11(2016:Nov.)
• Page Start: 1627
• Page End: 1634
• Publication Date: 2016-07-25
• Subjects: cerebrovascular disease -- epidemiology -- intracerebral hemorrhage -- risk factors -- stroke; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.13099
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract : Background and purpose: The incidence and case‐fatality rate (CFR) of primary intracerebral hemorrhage (PICH) over two decades were assessed in a prospective population‐based study. Methods: Cases of incident first‐ever PICH were recorded over a 2‐year period (2011–2012) from multiple sources in the district of L'Aquila, central Italy. Included patients were followed up to 1 year after the event to ascertain CFRs. Current data were compared with those previously collected from 1994 through 1998. Results: In all, 115 patients (52 men; 45.2%) with a first‐ever PICH were included. Mean age ± SD was 77.4 ± 11.8 years. The hemorrhage was lobar in 43 (37.4%) patients, deep in 56 (48.7%), in the posterior fossa in 11 (9.6%) and intraventricular or multiple localized in five (4.3%). Crude annual incidence rate was 19.3 per 100 000 and 14.8 per 100 000 when standardized to the 2011 European population, indicating a 48% reduction comparing data of 2011–2012 to those of 1994–1998 (incidence rate ratio 0.52; 95% confidence interval 0.43–0.64; P < 0.001). In 2011–2012, the 7‐day CFR was 27.8%, the 30‐day CFR was 42.6% and the 1‐year CFR was 52.2%; the 1‐year standardized mortality ratio was 0.81 (95% confidence interval 0.63–1.04) compared with 1994–1998. Conclusions: The annual incidence rate of PICH was lower than that found two decades before and close to the rates recently found in other western countries. Data also indicated a non‐significant trend towards a decrease in mortality, which nonetheless remained high, pointing to the need for more appropriate treatments in order to reduce PICH severity and mortality.