Beth Israel Deaconess Medical Center, Department of Neurology, Stroke Division, Boston, USA.
Curr Neurovasc Res. 2012 Feb;9(1):42-6. doi: 10.2174/156720212799297065.
The aim of this study was to assess short- and long-term outcomes of patients hospitalized with intracerebral hemorrhage (ICH) in South Carolina. Patients with a primary diagnosis of ICH (ICD-9-CM code 431) discharged during 2002 were identified in the South Carolina hospital discharge database. Kaplan-Meier estimates of recurrent stroke, myocardial infarct, vascular death, all-cause death, and composite events were calculated at 1 month, 6 months, and 1, 2, 3, and 4 years. Age- and race-specific survival curves were plotted. A total of 893 patients were discharged during 2002. Most were Caucasian (CA) (61.4%), followed by African American (AA) (37.4%). The mean age of patients in the AA group was 12 years younger than that of the CA group; of those in the AA group, 63.8% were < 65 years of age, and of those in the CA group, 27.4% were > 65 years of age. Kaplan-Meier estimates of cumulative risk increased with time over the 4-year period after discharge, and the risk of all-cause death was high (~40%-60%). Survival curves showed that the composite risk of recurrent stroke, myocardial infarct, or vascular death was higher for AA patients < 65 years of age compared to similarly aged CA patients, whereas the risk was higher for CA patients ≥65 years of age compared to similar age AA patients. The racial disparity in short- and long-term outcomes for ICH patients < 65 years of age in South Carolina highlights the need for improvements in stroke prevention, particularly among the AA population.
本研究旨在评估南卡罗来纳州因脑出血(ICH)住院患者的短期和长期结局。在南卡罗来纳州医院出院数据库中,确定了 2002 年期间因原发性 ICH(ICD-9-CM 代码 431)出院的患者。计算了 1 个月、6 个月和 1、2、3、4 年时复发性卒中、心肌梗死、血管性死亡、全因死亡和复合事件的 Kaplan-Meier 估计值。绘制了年龄和种族特异性生存曲线。2002 年共出院 893 例患者。大多数为白种人(CA)(61.4%),其次是非裔美国人(AA)(37.4%)。AA 组患者的平均年龄比 CA 组年轻 12 岁;AA 组中 63.8%的患者年龄<65 岁,CA 组中 27.4%的患者年龄>65 岁。出院后 4 年内,Kaplan-Meier 估计的累积风险随时间增加,全因死亡率较高(~40%-60%)。生存曲线表明,年龄<65 岁的 AA 患者复发性卒中、心肌梗死或血管性死亡的复合风险高于同龄 CA 患者,而年龄≥65 岁的 CA 患者的风险则高于同龄 AA 患者。南卡罗来纳州年龄<65 岁的 ICH 患者短期和长期结局的种族差异突出表明,需要改善卒中预防措施,尤其是在 AA 人群中。