Temporal trends in intracerebral hemorrhage: Evidence from the Austrian Stroke Unit Registry


Autoři: Christoph Schellen aff001;  Alexandra Posekany aff002;  Julia Ferrari aff003;  Stefan Krebs aff003;  Wilfried Lang aff003;  Michael Brainin aff002;  Dimitre Staykov aff005;  Marek Sykora aff003
Působiště autorů: Department of Radiology, Rudolf Foundation Hospital ("Krankenanstalt Rudolfstiftung"), Vienna, Austria aff001;  Department for Clinical Neurosciences and Preventive Medicine, Danube University, Krems, Austria aff002;  Department of Neurology, St. John's Hospital, Vienna, Austria aff003;  Medical Faculty, Sigmund Freud University, Vienna, Austria aff004;  Department of Neurology, St. John's Hospital, Eisenstadt, Austria aff005;  I. Department of Neurology, Comenius University, Bratislava, Slovakia aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225378

Souhrn

Background

To assess changes in frequency, severity, complications, therapy and outcome of intracerebral hemorrhage in patients treated in stroke units in Austria, we evaluated data from the Austrian Stroke Unit Registry between 2008 and 2016.

Methods and findings

Data of 6707 cases of ICH covering a time span of 9 years and including information on age, risk factors, pre-stroke modified Rankin Score (mRS), baseline stroke severity (NIHSS), complications, therapy, functional outcome, and mortality were extracted from the Austrian Stroke Unit Registry. A multivariate regularized logistic regression model and linear models for temporal dependence were computed for analyzing statistical inference and time trends. Bonferroni correction was applied to correct for multiple testing.

Between 2008 and 2016, the proportion of ICH admissions to stroke units in Austria declined, with a shift among patients towards older age (>70 years, p = 0.04) and lower admission NIHSS scores. While no significant time trends in risk factors, pre-stroke mRS and medical complications were observed, therapeutic interventions declined significantly (p<0.001). Three-month mortality increased over the years independently (p = 0.003).

Conclusions

Despite declining incidence and clinical severity of ICH we observed a clear increase in three-month mortality. This effect seems to be independent of predictors including age, admission NIHSS, pre-morbid MRS, or medical complications. The observations from this large retrospective database cohort study underline an urgent call for action in the therapy of ICH.

Klíčová slova:

Death rates – Hemorrhagic stroke – Intravenous injections – Intubation – Medical risk factors – stroke – Antihypertensive drug therapy


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Článek vyšel v časopise

PLOS One


2019 Číslo 11