Inagawa T
Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Stroke. 2001 Jul;32(7):1499-507. doi: 10.1161/01.str.32.7.1499.
With aging of the population, the profile of subarachnoid hemorrhage (SAH) is likely to change; however, evaluation of long-term trends for incidence and case fatality rates of SAH is still limited.
We compared the incidence and case fatality rates of aneurysmal SAH during the 9-year period 1990-1998 with those during the 10-year period 1980-1989 in Izumo City, Japan.
During 1980-1989 and 1990-1998, we diagnosed 170 and 188 patients as having aneurysmal SAH, respectively. The percentage of very elderly patients aged >/=80 years increased from 5% (8 patients) during 1980-1989 to 18% (33 patients) during 1990-1998 (P<0.001). The age-specific incidence rate of SAH has a tendency to increase with increasing age. The crude and the age- and sex-adjusted incidence rates using the 1995 population statistics for Japan were 21 and 23 per 100 000/y for all ages during 1980-1989 and 25 and 23 per 100 000/y during 1990-1998, respectively. The 3-month case fatality rate of patients aged </=79 years decreased from 38% during 1980-1989 to 26% during 1990-1998 (P=0.021), whereas the case fatality rates in patients aged >/=80 years were very high (63% and 79%, respectively) regardless of study periods. Consequently, the overall case fatality rates for patients with SAH were similar for the 2 study periods (39% and 36%).
The age- and sex-adjusted incidence rates of aneurysmal SAH were stable over the 19-year period since 1980 and, despite improvement of outcome in patients aged </=79 years, the overall case fatality rate was not lower because the improvements were counterbalanced by increasing numbers of very elderly patients
随着人口老龄化，蛛网膜下腔出血（SAH）的情况可能会发生变化；然而，对SAH发病率和病死率长期趋势的评估仍然有限。
我们比较了日本出云市1990 - 1998年9年间与1980 - 1989年10年间动脉瘤性SAH的发病率和病死率。
在1980 - 1989年和1990 - 1998年期间，我们分别诊断出170例和188例动脉瘤性SAH患者。年龄≥80岁的高龄患者比例从1980 - 1989年的5%（8例）增加到1990 - 1998年的18%（33例）（P<0.001）。SAH的年龄别发病率有随年龄增加而上升的趋势。使用1995年日本人口统计数据计算的所有年龄段的粗发病率以及年龄和性别调整后的发病率，在1980 - 1989年分别为每10万/年21例和23例，在1990 - 1998年分别为每10万/年25例和23例。年龄≤79岁患者的3个月病死率从1980 - 1989年的38%降至1990 - 1998年的26%（P = 0.021），而年龄≥80岁患者的病死率无论在哪个研究期间都非常高（分别为63%和79%）。因此，两个研究期间SAH患者的总体病死率相似（分别为39%和36%）。
自1980年以来的19年期间，动脉瘤性SAH的年龄和性别调整发病率稳定，尽管年龄≤79岁患者的预后有所改善，但总体病死率并未降低，因为这些改善被高龄患者数量的增加所抵消。
