根据年龄、性别和种族，随时间推移的脑出血发病率、病死率和功能结局：系统评价和荟萃分析。

Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis.

机构信息

Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, Netherlands.

出版信息

Lancet Neurol. 2010 Feb;9(2):167-76. doi: 10.1016/S1474-4422(09)70340-0. Epub 2010 Jan 5.

DOI:10.1016/S1474-4422(09)70340-0

PMID:20056489

Abstract

BACKGROUND

Since the early 1980s, imaging techniques have enabled population-based studies of intracerebral haemorrhage. We aimed to assess the incidence, case fatality, and functional outcome of intracerebral haemorrhage in relation to age, sex, ethnic origin, and time period in studies published since 1980.

METHODS

From PubMed and Embase searches with predefined inclusion criteria, we identified population-based studies published between January, 1980, and November, 2008. We calculated incidence and case fatality. Incidences for multiple studies were pooled in a random-effects binomial meta-analysis. Time trends of case fatality were assessed with weighted linear-regression analysis.

FINDINGS

36 eligible studies described 44 time periods (mid-year range 1983-2006). These studies included 8145 patients with intracerebral haemorrhage. Incidence did not decrease between 1980 and 2008. Overall incidence was 24.6 per 100 000 person-years (95% CI 19.7-30.7). Incidence was not significantly lower in women than in men (overall incidence ratio 0.85, 95% CI 0.61-1.18). Using the age group 45-54 years as reference, incidence ratios increased from 0.10 (95% CI 0.06-0.14) for people aged less than 45 years to 9.6 (6.6-13.9) for people older than 85 years. Median case fatality at 1 month was 40.4% (range 13.1-61.0) and did not decrease over time, and was lower in Japan (16.7%, 95% CI 15.0-18.5) than elsewhere (42.3%, 40.9-43.6). Six studies reported functional outcome, with independency rates of between 12% and 39%. Incidence of intracerebral haemorrhage per 100 000 person-years was 24.2 (95% CI 20.9-28.0) in white people, 22.9 (14.8-35.6) in black people, 19.6 (15.7-24.5) in Hispanic people, and 51.8 (38.8-69.3) in Asian people.

INTERPRETATION

Incidence of intracerebral haemorrhage increases with age and has not decreased between 1980 and 2006. Case fatality is lower in Japan than elsewhere, increases with age, and has not decreased over time. More data on functional outcome are needed.

FUNDING

Netherlands Heart Foundation.

摘要

背景

自 20 世纪 80 年代初以来，影像学技术使我们能够对颅内出血进行基于人群的研究。我们旨在评估自 1980 年以来发表的研究中与年龄、性别、种族起源和时间段有关的颅内出血的发病率、病死率和功能结局。

方法

我们从 PubMed 和 Embase 搜索中使用了预先确定的纳入标准，确定了 1980 年 1 月至 2008 年 11 月期间发表的基于人群的研究。我们计算了发病率和病死率。对于多个研究，我们使用随机效应二项式荟萃分析进行了汇总。使用加权线性回归分析评估病死率的时间趋势。

结果

36 项符合条件的研究描述了 44 个时间段（1983 年至 2006 年的中期范围）。这些研究包括 8145 名颅内出血患者。发病率自 1980 年以来并未降低。总体发病率为 24.6/100000 人年（95%CI19.7-30.7）。女性的发病率并不明显低于男性（总体发病率比 0.85，95%CI0.61-1.18）。以 45-54 岁年龄组为参照，发病率比从<45 岁的人群的 0.10（95%CI0.06-0.14）增加到>85 岁的人群的 9.6（6.6-13.9）。1 个月时的中位病死率为 40.4%（范围 13.1-61.0），且随时间无下降趋势，日本（16.7%，95%CI15.0-18.5）的病死率低于其他地区（42.3%，40.9-43.6）。6 项研究报告了功能结局，独立性率在 12%-39%之间。白人颅内出血的发病率为 24.2/100000 人年（95%CI20.9-28.0），黑人发病率为 22.9/100000 人年（14.8-35.6），西班牙裔为 19.6/100000 人年（15.7-24.5），亚洲人为 51.8/100000 人年（38.8-69.3）。