Department of Neurosurgery, University Clinics of Giessen and Marburg GmbH, Campus Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Stroke. 2012 Apr;43(4):1126-8. doi: 10.1161/STROKEAHA.111.644716. Epub 2012 Jan 26.
In most European societies and in the United States, the percentage of patients ≥80 years has been rising over the past century. The present study was conducted to observe this demographic change and its impact on patients with intracerebral hemorrhage (ICH).
We reviewed patients' data with the diagnosis of ICH from January 2007 to December 2009. All data were collected out of a prospective stroke registry covering the entire state of Hesse, Germany. Incidence rates and absolute numbers of patients with ICH for 2009 to 2050 were calculated.
Of 3448 patients, 34% had an age ≥80 years. Hospital mortality was 35.9% for patients ≥80 years and 20.0% for patients <80 years. Unfavorable outcome (modified Rankin Scale score >2) was more often found in patients ≥80 years compared with patients <80 years (84.9% versus 74.8%). By the year 2050, the proportion of all patients with ICH ≥80 years will be 2.5-fold higher than in 2009. The total number of ICH cases will increase approximately 35.2% assuming that ICH probability stays the same. The number of patients who die in the hospital will increase approximately 60.2%. The total number of patients with severe disability due to ICH will increase approximately 36.8%.
If current treatment strategies according to age remain unchanged, an increase of in-hospital mortality and a higher proportion of patients who need lifelong care after ICH can be expected in the coming decades.
在过去的一个世纪中，大多数欧洲社会和美国 80 岁以上的患者比例一直在上升。本研究旨在观察这一人口结构变化及其对颅内出血（ICH）患者的影响。
我们回顾了 2007 年 1 月至 2009 年 12 月期间以 ICH 诊断的患者数据。所有数据均来自德国黑森州的一项前瞻性卒中登记处。计算了 2009 年至 2050 年 ICH 患者的发病率和绝对人数。
在 3448 名患者中，34%的患者年龄≥80 岁。80 岁以上患者的住院死亡率为 35.9%，而 80 岁以下患者的死亡率为 20.0%。与 80 岁以下患者相比，80 岁以上患者的不良预后（改良 Rankin 量表评分>2）更为常见（84.9%比 74.8%）。到 2050 年，所有≥80 岁的 ICH 患者比例将是 2009 年的 2.5 倍。假设 ICH 概率保持不变，ICH 病例总数将增加约 35.2%。预计住院死亡人数将增加约 60.2%。因 ICH 导致严重残疾的患者总数将增加约 36.8%。
如果根据年龄保持当前的治疗策略不变，预计在未来几十年内，住院死亡率的增加和需要终身护理的 ICH 患者比例将会增加。
