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Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden

Nilsson, O G LU ; Lindgren, A LU ; Ståhl, N LU ; Brandt, L LU and Säveland, H LU (2000) In Journal of Neurology, Neurosurgery, and Psychiatry 69. p.601-607
Abstract

OBJECTIVES: Spontaneous intracranial haemorrhage-that is, mainly subarachnoid haemorrhage (SAH) and primary intracerebral haemorrhage (PICH)-constitutes an important part of all strokes. As previous epidemiological studies have demonstrated highly variable incidence rates, we conducted a large prospective investigation of all haemorrhagic strokes during a 1 year period.

METHODS: Twelve hospitals serving a defined population of 1.14 million in southern Sweden registered all cases with spontaneous intracranial haemorrhage, including those found dead outside hospitals, during 1996. All patients were examined with CT of the brain or underwent necropsy. Incidence rates adjusted to the Swedish population for age and sex, as well as... (More)

OBJECTIVES: Spontaneous intracranial haemorrhage-that is, mainly subarachnoid haemorrhage (SAH) and primary intracerebral haemorrhage (PICH)-constitutes an important part of all strokes. As previous epidemiological studies have demonstrated highly variable incidence rates, we conducted a large prospective investigation of all haemorrhagic strokes during a 1 year period.

METHODS: Twelve hospitals serving a defined population of 1.14 million in southern Sweden registered all cases with spontaneous intracranial haemorrhage, including those found dead outside hospitals, during 1996. All patients were examined with CT of the brain or underwent necropsy. Incidence rates adjusted to the Swedish population for age and sex, as well as location of haematoma and prevalence of risk factors were calculated.

RESULTS: A total of 106 patients with SAH and 341 patients with PICH were identified. The annual incidence/100 000 was 10.0 (6.4 for men and 13.5 for women) for SAH and 28.4 (32.2 for men and 24.7 for women) for PICH when adjusted to the Swedish population. Subarachnoid haemorrhage affected twice as many women as men. The incidence of both types of haemorrhage increased with advancing age, but in particular, this was the case for supratentorial PICH. Lobar haematomas were the most common (51.6%) type of PICH. Among patients with PICH, 37% had hypertension, 41% other vascular disease, and 12% were on oral anticoagulation. Among patients with SAH, 28% had hypertension and 18% vascular disease before the haemorrhage but no one was on treatment with oral anticoagulation.

CONCLUSIONS: The incidence of PICH was high, especially for the older age groups. PICH was, on average, three times as common as SAH. The study underscores the importance of PICH and SAH as significant stroke subgroups.

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keywords
Adult, Age Distribution, Aged, Aged, 80 and over, Cerebral Hemorrhage/epidemiology, Female, Humans, Incidence, Male, Middle Aged, Prevalence, Risk Factors, Sex Distribution, Subarachnoid Hemorrhage/epidemiology, Sweden/epidemiology
in
Journal of Neurology, Neurosurgery, and Psychiatry
volume
69
pages
601 - 607
publisher
BMJ Publishing Group
external identifiers
  • scopus:0033784125
ISSN
0022-3050
DOI
10.1136/jnnp.69.5.601
language
English
LU publication?
yes
id
0836b029-f9d8-4166-a6b5-c6702a47a052
date added to LUP
2019-06-25 09:47:58
date last changed
2019-09-09 14:50:15
@article{0836b029-f9d8-4166-a6b5-c6702a47a052,
  abstract     = {<p>OBJECTIVES: Spontaneous intracranial haemorrhage-that is, mainly subarachnoid haemorrhage (SAH) and primary intracerebral haemorrhage (PICH)-constitutes an important part of all strokes. As previous epidemiological studies have demonstrated highly variable incidence rates, we conducted a large prospective investigation of all haemorrhagic strokes during a 1 year period.</p><p>METHODS: Twelve hospitals serving a defined population of 1.14 million in southern Sweden registered all cases with spontaneous intracranial haemorrhage, including those found dead outside hospitals, during 1996. All patients were examined with CT of the brain or underwent necropsy. Incidence rates adjusted to the Swedish population for age and sex, as well as location of haematoma and prevalence of risk factors were calculated.</p><p>RESULTS: A total of 106 patients with SAH and 341 patients with PICH were identified. The annual incidence/100 000 was 10.0 (6.4 for men and 13.5 for women) for SAH and 28.4 (32.2 for men and 24.7 for women) for PICH when adjusted to the Swedish population. Subarachnoid haemorrhage affected twice as many women as men. The incidence of both types of haemorrhage increased with advancing age, but in particular, this was the case for supratentorial PICH. Lobar haematomas were the most common (51.6%) type of PICH. Among patients with PICH, 37% had hypertension, 41% other vascular disease, and 12% were on oral anticoagulation. Among patients with SAH, 28% had hypertension and 18% vascular disease before the haemorrhage but no one was on treatment with oral anticoagulation.</p><p>CONCLUSIONS: The incidence of PICH was high, especially for the older age groups. PICH was, on average, three times as common as SAH. The study underscores the importance of PICH and SAH as significant stroke subgroups.</p>},
  author       = {Nilsson, O G and Lindgren, A and Ståhl, N and Brandt, L and Säveland, H},
  issn         = {0022-3050},
  keyword      = {Adult,Age Distribution,Aged,Aged, 80 and over,Cerebral Hemorrhage/epidemiology,Female,Humans,Incidence,Male,Middle Aged,Prevalence,Risk Factors,Sex Distribution,Subarachnoid Hemorrhage/epidemiology,Sweden/epidemiology},
  language     = {eng},
  pages        = {601--607},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Neurology, Neurosurgery, and Psychiatry},
  title        = {Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden},
  url          = {http://dx.doi.org/10.1136/jnnp.69.5.601},
  volume       = {69},
  year         = {2000},
}