Journal article
Intracerebral hemorrhage mortality is not changing despite declining incidence
Neurology, v 82(24), pp 2180-2186
17 Jun 2014
PMID: 24838789
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To determine trends in incidence and mortality of intracerebral hemorrhage (ICH) in a rigorous population-based study.
We identified all cases of spontaneous ICH in a South Texas community from 2000 to 2010 using rigorous case ascertainment methods within the Brain Attack Surveillance in Corpus Christi Project. Yearly population counts were determined from the US Census, and deaths were determined from state and national databases. Age-, sex-, and ethnicity-adjusted incidence was estimated for each year with Poisson regression, and a linear trend over time was investigated. Trends in 30-day case fatality and long-term mortality (censored at 3 years) were estimated with log-binomial or Cox proportional hazards models adjusted for demographics, stroke severity, and comorbid disease.
A total of 734 cases of ICH were included. The age-, sex-, and ethnicity-adjusted ICH annual incidence rate was 5.21 per 10,000 (95% confidence interval [CI] 4.36, 6.24) in 2000 and 4.30 per 10,000 (95% CI 3.21, 5.76) in 2010. The estimated 10-year change in demographic-adjusted ICH annual incidence rate was -31% (95% CI -47%, -11%). Yearly demographic-adjusted 30-day case fatality ranged from 28.3% (95% CI 19.9%, 40.3%) in 2006 to 46.5% (95% CI 35.5, 60.8) in 2008. There was no change in ICH case fatality or long-term mortality over time.
ICH incidence decreased over the past decade, but case fatality and long-term mortality were unchanged. This suggests that primary prevention efforts may be improving over time, but more work is needed to improve ICH treatment and reduce the risk of death.
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Details
- Title
- Intracerebral hemorrhage mortality is not changing despite declining incidence
- Creators
- Darin B Zahuranec - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann Arbor. zdarin@umich.eduLynda D Lisabeth - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborBrisa N Sánchez - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborMelinda A Smith - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborDevin L Brown - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborNelda M Garcia - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborLesli E Skolarus - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborWilliam J Meurer - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborJames F Burke - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborEric E Adelman - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann ArborLewis B Morgenstern - From the Stroke Program, Department of Neurology (D.B.Z., L.D.L., B.N.S., M.A.S., D.L.B., N.M.G., L.E.S., W.J.M., J.F.B., E.E.A., L.B.M.), and Department of Emergency Medicine (W.J.M., L.B.M.), University of Michigan Medical School; and the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann Arbor
- Publication Details
- Neurology, v 82(24), pp 2180-2186
- Publisher
- United States
- Grant note
- R18 HS017690 / AHRQ HHS R01NS070941 / NINDS NIH HHS R01NS038916 / NINDS NIH HHS R01HL071759 / NHLBI NIH HHS K23 AG038731 / NIA NIH HHS P60-MD002249 / NIMHD NIH HHS R01HL098065 / NHLBI NIH HHS K23AG038731 / NIA NIH HHS R01 HL071759 / NHLBI NIH HHS R01NS38916 / NINDS NIH HHS R01 DC012760 / NIDCD NIH HHS R01HL070941 / NHLBI NIH HHS R01 NS070941 / NINDS NIH HHS U01 NS056975 / NINDS NIH HHS UL1 TR000433 / NCATS NIH HHS R01 NS062675 / NINDS NIH HHS U01NS073476 / NINDS NIH HHS R01ES-021446 / NIEHS NIH HHS P60 MD002249 / NIMHD NIH HHS P50 NS044283 / NINDS NIH HHS P30ES01788501 / NIEHS NIH HHS R01NS062675 / NINDS NIH HHS K23 NS073685 / NINDS NIH HHS R01 NS038916 / NINDS NIH HHS P30 ES017885 / NIEHS NIH HHS P20SE01817101 / SEPDPO CDC HHS K23NS073685 / NINDS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000337706700011
- Scopus ID
- 2-s2.0-84904016352
- Other Identifier
- 991014877709304721
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