Eden S V, Meurer W J, Sánchez B N, Lisabeth L D, Smith M A, Brown D L, Morgenstern L B
Stroke Program, University of Michigan, Cardiovascular Center Room 3194, SPC 5855, Ann Arbor, MI 48109-5855, USA.
Neurology. 2008 Sep 2;71(10):731-5. doi: 10.1212/01.wnl.0000319690.82357.44. Epub 2008 Jun 11.
Mexican Americans (MAs) comprise the largest component of the largest minority group within the United States. The purpose of this study was to examine ethnic and gender differences in the epidemiology, presentation, and outcomes after subarachnoid hemorrhage (SAH) in a representative United States community. Targeted public health interventions are dependent on accurate assessments of groups at highest disease risk.
All patients with nontraumatic SAH older than 44 years were prospectively identified from January 1, 2000, to December 31, 2006, as part of the Brain Attack Surveillance In Corpus Christi project, an urban population-based study in southeast Texas. Risk ratios for cumulative SAH incidence comparing MAs with non Hispanic whites (NHWs) and women with men were calculated. Descriptive statistics for other clinical and demographic variables were computed overall, by gender, and by ethnicity.
A total of 107 patients had a SAH during the time period (7-year cumulative incidence: 11/10,000); of these, 43 were NHW (40% of cases vs 53% of the population) and 64 were MA (60% of cases vs 48% of the population). The overall age-adjusted risk ratio for SAH in MAs compared with NHWs was 1.67 (95% CI: 1.13, 2.47), and in women compared to men was 1.74 (95% CI 1.16, 2.62). Overall in-hospital mortality was 32.2%. No ethnic difference was observed for discharge disability or in-hospital mortality.
Subarachnoid hemorrhage disproportionately affects Mexican Americans and women. Public health interventions should target these groups to reduce the impact of this severe disease.
墨西哥裔美国人（MAs）是美国最大少数族裔群体的最大组成部分。本研究的目的是在美国一个具有代表性的社区中，研究蛛网膜下腔出血（SAH）在流行病学、临床表现及预后方面的种族和性别差异。有针对性的公共卫生干预措施依赖于对疾病风险最高群体的准确评估。
作为“科珀斯克里斯蒂脑卒中考察项目”（一项在得克萨斯州东南部以城市人口为基础的研究）的一部分，前瞻性地确定了2000年1月1日至2006年12月31日期间所有年龄大于44岁的非创伤性SAH患者。计算了墨西哥裔美国人与非西班牙裔白人（NHWs）以及女性与男性累积SAH发病率的风险比。总体上、按性别以及按种族计算了其他临床和人口统计学变量的描述性统计数据。
在此期间共有107例患者发生SAH（7年累积发病率：11/10000）；其中，43例为非西班牙裔白人（占病例的40%，而占人口的53%），64例为墨西哥裔美国人（占病例的60%，而占人口的48%）。与非西班牙裔白人相比，墨西哥裔美国人SAH的总体年龄调整风险比为1.67（95%可信区间：1.13，2.47），女性与男性相比为1.74（95%可信区间1.16，2.62）。总体住院死亡率为32.2%。在出院时的残疾情况或住院死亡率方面未观察到种族差异。
蛛网膜下腔出血对墨西哥裔美国人和女性的影响尤为严重。公共卫生干预措施应针对这些群体，以减轻这种严重疾病的影响。
