Epidemiology

Flaherty, Matthew L.; Woo, Daniel; Broderick, Joseph P.

doi:10.1017/cbo9780511691836.002

Cited by 11 publications

(17 citation statements)

References 146 publications

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“… 27 – 31 The difference between the trends for the 2 stroke types was greater in the European, North American and Australian studies than in the Asian studies, perhaps reflecting variation in the epidemiology of different stroke types in these different populations. 32 As in our study, there was no evidence that the BMI association differed for subarachnoid and intracerebral hemorrhage in the 2 large Asian cohort studies that estimated separate trends for these types. 25 , 26 …”

Section: Discussioncontrasting

confidence: 62%

Adiposity and ischemic and hemorrhagic stroke

et al. 2016

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Objective:To compare associations of body mass index (BMI) with ischemic stroke and hemorrhagic stroke risk, and to review the worldwide evidence.Methods:We recruited 1.3 million previously stroke-free UK women between 1996 and 2001 (mean age 57 years [SD 5]) and followed them by record linkage for hospital admissions and deaths. We used Cox regression to estimate adjusted relative risks for ischemic and hemorrhagic (intracerebral or subarachnoid hemorrhage) stroke in relation to BMI. We conducted a meta-analysis of published findings from prospective studies on these associations.Results:During an average follow-up of 11.7 years, there were 20,549 first strokes, of which 9,993 were specified as ischemic and 5,852 as hemorrhagic. Increased BMI was associated with an increased risk of ischemic stroke (relative risk 1.21 per 5 kg/m2 BMI, 95% confidence interval 1.18–1.23, p < 0.0001) but a decreased risk of hemorrhagic stroke (relative risk 0.89 per 5 kg/m2 BMI, 0.86–0.92, p < 0.0001). The BMI-associated trends for ischemic and hemorrhagic stroke were significantly different (heterogeneity: p < 0.0001) but were not significantly different for intracerebral hemorrhage (n = 2,790) and subarachnoid hemorrhage (n = 3,062) (heterogeneity: p = 0.5). Published data from prospective studies showed consistently greater BMI-associated relative risks for ischemic than hemorrhagic stroke with most evidence (prior to this study) coming from Asian populations.Conclusions:In UK women, higher BMI is associated with increased risk of ischemic stroke but decreased risk of hemorrhagic stroke. The totality of the available published evidence suggests that BMI-associated risks are greater for ischemic than for hemorrhagic stroke.

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Section: Discussioncontrasting

confidence: 62%

Adiposity and ischemic and hemorrhagic stroke

et al. 2016

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“…Stroke is the second leading cause of death worldwide and the third leading cause of death in Norway [ 1 , 2 ]. Intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes in Western countries, with an incidence rate of 0.1-0.3/1,000/year [ 3 ]. Morbidity and case fatality are high: only 12-39% of patients live independently after an ICH and case fatality rates at 1 month range between 13 and 61% (median 40%) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Temporal Trends in Incidence and Case Fatality of Intracerebral Hemorrhage: The Tromsø Study 1995-2012

Carlsson¹,

Wilsgaard²,

Johnsen³

et al. 2016

Cerebrovasc Dis Extra

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Background: The aim of this study was to explore temporal trends in incidence and case fatality rates of intracerebral hemorrhage (ICH) over the last two decades in a Norwegian municipality. Methods: Incident cases of primary ICH were registered in the period from 1995 through 2012 in 32,530 participants of the longitudinal population-based Tromsø Study. Poisson regression models were used to obtain incidence rates over time in age- and sex-adjusted and age- and sex-specific models. Case fatality rates were calculated and age- and sex-adjusted trends over time were estimated using logistic regression. Results: A total of 226 ICHs were registered. The age- and sex-adjusted incidence rate [95% confidence interval (CI)] in the overall population was 0.42 (0.37-0.48) per 1,000 person-years. Age-adjusted incidence rates were 0.53 (0.43-0.62) in men and 0.33 (0.26-0.39) in women. In individuals aged <75 years, the age- and sex-adjusted incidence rate was 0.27 (0.22-0.32) and in individuals aged ≥75 years, it was 2.42 (1.95-2.89) per 1,000 person-years. There was no significant change in incidence rates over time. The incidence rate ratio (95% CI) in the overall population was 0.73 (0.47-1.12) in 2012 compared with 1995. The overall 30-day case fatality (95% CI) was 23.9% (18.3-29.5) and did not change substantially over time [odds ratio in 2012 vs. 1995 = 0.83 (95% CI 0.27-2.52)]. Conclusion: No significant changes in incidence and case fatality rates of ICH were observed during the last two decades.

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“…Flaherty et al, [19] Other studies reported another risk factor as Arboix et al, [23] reported diabetes mellitus as an independent risk factor of early mortality while Kurth et al, [24] reported smoking as a risk factor for ICH. Regarding to line of treatment, we found 6 cases of 13 patients with HTN (46%) treated conservatively with mortality of (50%), and 7 cases out of 13 patients (54%) treated surgically with mortality of (57%), with no any significant difference in outcome (P-value 0.639), which is the same as reported by Yilmaz et al, [10] as they found that hypertension was the most commonly seen disease in patients with ICH (78%), but it did not have any effect on outcome.…”

Section: Discussionmentioning

confidence: 99%

Management of Spontaneous Superficial Intracerebral Hematomas

Mahmoud¹,

Abokresha²

2020

OJMN

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Background: Treatment of primary spontaneous superficial intracerebral hemorrhage (SSICH) is still controversial. The aim of this study is to investigate the effectiveness of craniotomy and early hematoma evacuation vs conservative (non operative) management in patients with SSICH. Methods: A prospective study of craniotomy and early hematoma removal vs. medical management was performed in 20 patients with cortical and subcortical (superficial) primary SSICH admitted to Assiut university hospital in one year period (March 2016-March 2017). Surgical or medical treatment was initiated immediately when patients admitted to hospital. We divided the patients into two groups according to type of treatment. Results: Age of the patients ranged from 2 months to 73 years (mean: 45.84 ± 23.28 years) among the 20 patients studied; 13 (65%) were males and 7 (35%) were females. Glasgow coma scale (GCS) at admission was less than 8 in 25%, between 8-12 in 45% and 15 in 30% of the patients. Arterial hypertension was the most common associated medical disease (65%). Eleven of patients (55%) had ventricular extension. GCS at admission was the strongest factor affecting outcomes and determined the type of treatment. All patients with a GCS ≤ 8 (5 cases (25%) were died regardless the type of treatment and there was no significant statistical difference in this group in relation to type of treatment p-value (0.606). We had 6 cases (30%) with a GCS 15; all of them were treated conservatively and all of them survived with significant p-value (0.003). Nine patients (45%) had GCS 8-12; two of them were treated conservatively and died while the remaining seven patients were treated surgically; five of them survived with significant p-value (0.025). No significant statistical difference was found in the outcome between the surgical and the conservative group regarding having associated intracranial hemorrhage. Conclusions: After analyzing the results, we found that when the GCS is "8-12", surgical intervention is recommended and carried a better prognosis than waiting for the conservative treatment. When GCS is higher ">12", conservative treatment can be the fa-How to cite this paper:

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Epidemiology

Cited by 11 publications

References 146 publications

Adiposity and ischemic and hemorrhagic stroke

Adiposity and ischemic and hemorrhagic stroke

Temporal Trends in Incidence and Case Fatality of Intracerebral Hemorrhage: The Tromsø Study 1995-2012

Management of Spontaneous Superficial Intracerebral Hematomas

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