Abstract W MP87: Lack of Improvement in Incidence and Case-Fatality of First Time Hospital Admission With Intracerebral Hemorrhage in Denmark 2004-2012
Background: The mortality from ischemic stroke and other ischemic cardiovascular events have declined substantially in the last decades. Less is known about the epidemiology of intracerebral hemorrhage (ICH). However, the distribution of major modifiable risk factors, particularly hypertension, smoking, and use of antithrombotic medications changes rapidly in most populations, which underlines the need for updated data.
Objectives: To examine trends in incidence of first hospitalization due to ICH and subsequent 30-day case-fatality in Denmark 2004-2012.
Methods: We performed a nationwide population-based cohort study. Patients with a first hospitalization due to ICH were identified in the Danish Stroke Registry and followed using the Danish Civil Registration System to determine 30-days case-fatality. We calculated the standardized incidence rates of hospitalization for ICH. Using 2004 as reference, we used multivariable logistic regression with 95% confidence interval to estimate the odds ratio (OR) of death according to year of admission adjusting for age, gender, diabetes, atrial fibrillation, hypertension, previous myocardial infarction, diabetes, smoking, alcohol intake, and quality of in-hospital stroke care.
Results: We identified 7850 patients with incident ICH (51.7 % men, median age 74 years). The overall standardized incidence rate (SIR) was 20.9 per 100.000 person years (95% CI: 19.5-22.3) and slightly higher among men compared with women. The SIR remained stable throughout the study period (2004: 20.7 (95% CI: 19.3-22.1) vs. 2012: 18.2 (95% CI: 16.9-19.5)). The average 30-day case-fatality was 31.2%. The adjusted OR for 30-day case-fatality was 1.24 (95% CI: 0.94-1.64) when comparing 2012 with 2004.
Conclusions: The incidence rate of first hospitalization due to ICH and subsequent case-fatality have remained stable in Denmark in recent years despite increased focus on modifiable risk factors and improved early in-hospital stroke care.
Author Disclosures: T. Ottosen: None. M. Schmitz: None. M. Schmidt: None. J. Jacobsen: None. G. Andersen: None. S. Johnsen: None.
- © 2014 by American Heart Association, Inc.