Inagawa T, Takahashi M, Aoki H, Ishikawa S, Yoshimoto H
Department of Neurosurgery, Shimane Prefectural Central Hospital, Japan.
Stroke. 1988 Feb;19(2):176-80. doi: 10.1161/01.str.19.2.176.
The overall outcome of patients with aneurysmal subarachnoid hemorrhage was investigated in Izumo City and Shimane Prefecture. Of the patients from Izumo City, the clinical grade on admission was Grade I or II in 41% and Grade IV or V in 31%. Of those from Shimane Prefecture, 49% were graded as Grade I or II and 24% as Grade IV or V. The overall mortality rates 1 year after subarachnoid hemorrhage were 46% for Izumo City and 35% for Shimane Prefecture, while the surgical mortality rates were 18 and 15%, respectively. The mortality rates were particularly high among the elderly over the age of 70 years and among unoperated cases. The leading cause of death in these cases was the effect of aneurysm rupture itself, followed by rebleeding and vasospasm. The 5-year survival probabilities according to life table analysis were 50% for Izumo City and 59% for Shimane Prefecture, and a significant difference was observed in survival curves between Izumo City and Shimane Prefecture. It is concluded that the smaller the community studied, the less favorable the overall outcome, mainly because of poorer clinical conditions on admission.
对出云市和岛根县的动脉瘤性蛛网膜下腔出血患者的总体预后进行了调查。在出云市的患者中，入院时临床分级为Ⅰ级或Ⅱ级的占41%，Ⅳ级或Ⅴ级的占31%。在岛根县的患者中，49%被分级为Ⅰ级或Ⅱ级，24%为Ⅳ级或Ⅴ级。蛛网膜下腔出血1年后的总体死亡率，出云市为46%，岛根县为35%，而手术死亡率分别为18%和15%。70岁以上的老年人和未接受手术的病例死亡率尤其高。这些病例的主要死亡原因是动脉瘤破裂本身的影响，其次是再出血和血管痉挛。根据生命表分析，出云市的5年生存概率为50%，岛根县为59%，出云市和岛根县的生存曲线存在显著差异。得出的结论是，研究的社区越小，总体预后越差，主要是因为入院时临床状况较差。
