Trends of Spontaneous Intracerebral Hemorrhage in Florence District Along Fifteen Years: A Brief Report
Clinical Neurology and Neuroscience
Volume 1, Issue 1, February 2017, Pages: 1-4
Received: Jan. 13, 2017; Accepted: Jan. 25, 2017; Published: Feb. 21, 2017
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Luca Masotti, Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
Federico Moroni, Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
Vieri Vannucchi, Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
Guido Grossi, Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
Giancarlo Landini, Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
Filippo Cellai, Department of Informatic and Health Tecnologies, ESTAR, Tuscany, Italy
Stefano Spolveri, Internal Medicine, Borgo San Lorenzo Hospital, Florence, Italy
Mauro Pratesi, Emergency Department, Santa Maria Nuova Hospital, Florence, Italy
Anna Poggesi, Neuroscience Section, NEUROFARBA Department, University of Florence, Florence, Italy
Domenico Inzitari, Neuroscience Section, NEUROFARBA Department, University of Florence, Florence, Italy
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Spontaneous intracerebral hemorrhage (ICH) represents the most feared stroke subtype. Real world epidemiological data about trends in incident cases and in-hospital mortality lack. Therefore we performed this study aimed to answer this concern. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9th CM) database referred to patients discharged from six Hospitals of Florence district, Tuscany, Italy in a period fifteen years long (2001-2015)was analyzed. We searched for code 431 as primary or secondary diagnosis at hospital discharge. Overall, 7452 patients were discharged with ICH as primary or secondary diagnosis. Of them, 3695 (49.5%) were females and 4363 (59.1%) were 75-years old and over. Cases of ICH increased from 461 in 2001 to 568 in 2015. The greatest increase was observed in patients 75 years old and over (216 cases in 2001, 339 cases in 2015). Overall, 2273 patients died during hospital stay, in-hospital mortality being 30.5%. In-hospital mortality increased according to age, being 18% in under 65 years and 35.9% in 75-years old and over. In-hospital mortality decreased from 30.8% in 2001 to 25.1% in 2015. The decrease in in-hospital mortality was observed irrespective of age. In Florence district, cases of ICH increased over the years, especially in very old people, whereas in-hospital mortality decreased irrespective of age.
Intracerebral Hemorrhage, Epidemiology, Mortality, Elderly
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Luca Masotti, Federico Moroni, Vieri Vannucchi, Guido Grossi, Giancarlo Landini, Filippo Cellai, Stefano Spolveri, Mauro Pratesi, Anna Poggesi, Domenico Inzitari, Trends of Spontaneous Intracerebral Hemorrhage in Florence District Along Fifteen Years: A Brief Report, Clinical Neurology and Neuroscience. Vol. 1, No. 1, 2017, pp. 1-4. doi: 10.11648/j.cnn.20170101.11
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Qureshi AI, Thurim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Eng J Med 2001; 344: 1450-60.
Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage. Lancet 2009; 373: 1632-44.
Van Asch C, Luitse MA, Rinkel GE, van der Tweel I, Klijn CM. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol 2010; 9: 167-76.
Qureshi AI, Suri MFK, Nasar A et al. Changes in cost and outcome among US patients with stroke hospitalized in 1990 to 1991 and those hospitalized in 2000 to 2001. Stroke 2007; 38: 2180-4.
Lovelock CE, Molyneux AJ, Rothwell PM; Oxford Vascular Study. Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study. Lancet Neurol 2007; 6: 487-93.
Sacco S, Marini C, Toni D, Olivieri L, Carolei A. Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke 2009; 40: 394-9.
Masotti L, Filippi S, Acciai S et al. Epidemiology of intracerebral hemorrhage in Livorno district. Rev Health Care 2011; 2 (suppl 1): 5-13.
Zahuranec DB, Lisabeth LD, Sánchez BN et al. Intracerebral hemorrhage mortality is not changing despite declining incidence. Neurology 2014;82:2180-6.
Masotti L, Di Napoli M, Godoy DA et al. The practical management of intracerebral hemorrhage associated with oral anticoagulant therapy. Int J Stroke 2011;6:228-40.
Qureshi AI, Palesch YY, Barsan WG et al.; ATACH-2 Trial Investigators and the Neurological Emergency Treatment TrialsNetwork.. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med 2016;375:1033-4.
Manning LS, Robinson TG. New Insights into Blood Pressure Control for Intracerebral Haemorrhage. Front NeurolNeurosci2015;37:35-50.
Mendelow AD, Gregson BA, Rowan EN, Murray GD, Gholkar A, Mitchell PM; STICH II Investigators. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet 2013;382:397-408.
Hemphill JC 3rd, Greenberg SM, Anderson CS et. al.; American Heart Association Stroke Council.; Council on Cardiovascular and Stroke Nursing.; Council on Clinical Cardiology.. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2015; 46:2032-60.
Steiner T, Al-Shahi Salman R, Beer R et al.: European Stroke Organisation.. European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke 2014;9:840-55.
Flaherty ML, Kissela B, Woo D et al. The increasing incidence of oral anticoagulant-associated intracerebral haemorrhage. Neurology 2007;68:116-21.
Schols AM, Schreuder FH, van Raak EP et al. Incidence of oral anticoagulant-associated intracerebral hemorrhage in the Netherlands. Stroke 2014;45:268-70.
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