Stapf C, Mast H, Sciacca R R, Berenstein A, Nelson P K, Gobin Y P, Pile-Spellman J, Mohr J P
Stroke Center, The Neurological Institute, Columbia University College of Physicians and Surgeons, 710 W 168th St, New York, NY 10032, USA.
Stroke. 2003 May;34(5):e29-33. doi: 10.1161/01.STR.0000068784.36838.19. Epub 2003 Apr 10.
Prospective population-based data on the incidence of brain arteriovenous malformation (AVM) hemorrhage are scarce. We studied lifetime detection rates of brain AVM and incident AVM hemorrhage in a defined population.
The New York islands (ie, Manhattan Island, Staten Island, and Long Island) comprise a 9,429,541 population according to the 2000 census. Since March 15, 2000, all major New York islands hospitals have prospectively reported data on consecutive patients living in the study area with a diagnosis of brain AVM and whether the patient had suffered AVM hemorrhage. Patients living outside the ZIP code-defined study area were excluded from the study population.
As of June 14, 2002, 284 prospective AVM patients (mean+/-SD age, 35+/-18 years; 49% women) were encountered during 21,216,467 person-years of observation, leading to an average annual AVM detection rate of 1.34 per 100,000 person-years (95% CI, 1.18 to 1.49). The incidence of first-ever AVM hemorrhage (n=108; mean age, 31+/-19 years; 45% women) was 0.51 per 100,000 person-years (95% CI, 0.41 to 0.61). The estimated prevalence of AVM hemorrhage among detected cases (n=144; mean age, 33+/-19 years; 50% women) was 0.68 per 100,000 (95% CI, 0.57 to 0.79).
Our prospective data, spanning 27 months, suggest stable rates for AVM detection and incident AVM hemorrhage. Approximately half of AVM patients may suffer intracranial hemorrhage.
基于人群的脑动静脉畸形（AVM）出血发生率的前瞻性数据较为匮乏。我们研究了特定人群中脑AVM的终生检出率和AVM出血的发生率。
根据2000年人口普查，纽约诸岛（即曼哈顿岛、斯塔滕岛和长岛）的人口为9,429,541。自2000年3月15日起，纽约诸岛所有主要医院均前瞻性地报告了居住在研究区域内被诊断为脑AVM的连续患者的数据，以及患者是否发生过AVM出血。居住在邮政编码定义的研究区域之外的患者被排除在研究人群之外。
截至2002年6月14日，在21,216,467人年的观察期内，共遇到284例前瞻性AVM患者（平均年龄±标准差为35±18岁；49%为女性），导致平均每年AVM检出率为每100,000人年1.34例（95%置信区间，1.18至1.49）。首次AVM出血的发生率（n = 108；平均年龄，31±19岁；45%为女性）为每100,000人年0.51例（95%置信区间，0.41至0.61）。在已检出病例中（n = 144；平均年龄，33±19岁；50%为女性），AVM出血的估计患病率为每100,000人0.68例（95%置信区间，0.57至0.79）。
我们为期27个月的前瞻性数据表明，AVM检出率和AVM出血发生率稳定。约一半的AVM患者可能发生颅内出血。
