A1 Refereed original research article in a scientific journal
Case fatality of hospital-treated intracerebral hemorrhage in Finland - A nationwide population-based registry study
Authors: Sipilä Jussi OT, Ruuskanen Jori O, Rautava Päivi, Kytö Ville
Publisher: Elsevier BV
Publication year: 2021
Journal: Journal of the Neurological Sciences
Journal name in source: Journal of the neurological sciences
Journal acronym: J Neurol Sci
Article number: 117446
Volume: 425
ISSN: 0022-510X
eISSN: 1878-5883
DOI: https://doi.org/10.1016/j.jns.2021.117446
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/56326922
Case-fatality of Intracerebral hemorrhage (ICH) has been reported to have improved in some areas recently. Previous reports have shown that in Finland ICH survival has improved already from the 1980s. We aimed to investigate if this trend has continued and to assess possible predictors for death.
All patients hospitalized for ICH in Finland in 2004-2018 over 16 years of age were identified from a national registry. Survival was analyzed using the national causes of death registry with median follow-up of 5.1 years (max 15.0 years).
20,391 persons with ICH (53.5% men) were identified. Patient age increased during the study period with men being younger than women. One-month case-fatality was 28.4% and decreased during the study period. One-month and long-term case-fatality increased with patient age. Five-year survival was over 64% in patients <65 years of age and < 33% in those >75 years of age. In a multivariate analysis patient age, sex, comorbidity burden and diagnoses of atrial fibrillation, hypertension and coagulopathy were all independently associated with both 30-day and long-term survival. Survival was better in men than women at all time points but in the multivariate analysis male sex was associated with a slightly higher risk (hazard ratio 1.10, 95% CI 1.06-1.14) of death in the long-term follow-up. Compared to general population, excess case-fatality was high and highly age-dependent in both sexes.
Case-fatality of hospital-treated ICH has continued to decrease in Finland. Prognosis is strongly associated with patient age and more modestly with patient sex and comorbidities.
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