Mortality Outcomes in 35,433 Patients Admitted for Acute Haemorrhagic Stroke in Australia: A Population-Linkage Study
International Journal of Cardiology Cardiovascular Risk and Prevention(2024)
摘要
Background: Haemorrhagic stroke (HS) is an important cardiovascular cause of mortality worldwide. Trends in admission rates and outcomes, and predictors of outcomes, post -HS in Australia remain unclear. Methods: All New South Wales residents, Australia, hospitalized with HS from 2002 to 2017 were identified from the Admitted -Patient -Data -Collection database. Admission rates were adjusted to population size by sex, agegroups and calendar -year. Mortality was tracked from the death registry to 31 -Dec -2018 and adjusted for admission calendar -year, age, gender, referral source, surgical evacuation following HS and comorbidities. Results: The cohort comprised 35,433 patients (51.1% males). Overall age -adjusted mean( +/- SD) admission rates were higher for males (63.6 +/- 6.2 vs 49.9 +/- 4.4 admissions -per -100,000 -persons -per -annum). Annual admission rates declined for both sexes from 2002 to 2017 especially in those >= 60yo. In -hospital and 1 -year mortality rates were higher for females than males (25.0% vs 20.0% and 40.6% vs 35.9% respectively, all p < 0.001). Adjusted in -hospital and 1 -year mortality declined for men and women, overall decreasing by 45% (odds ratio 0.55, 95% confidence interval [CI] = 0.47 -0.64), and 31% (hazard ratio 0.69,95%CI = 0.63 -0.76) respectively between 2002 and 2017. Independent predictors of increased in -hospital and 1 -year mortality included increasing age and Charlson comorbidity index, while male sex, a history of hyperlipidaemia and current smoking, and surgical evacuation following HS were associated with reduced mortality (all p < 0.001). Conclusion: HS incidence increases markedly with age. Although age -adjusted HS admission rates and post HS mortality have fallen, HS remains associated with high early and 1 -year mortality, with females consistently associated with worse outcomes. Strategies to improve outcomes of these patients remain a clinical priority.
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