Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry

Background and Purpose-The purpose of this study was to evaluate the incidence and prognosis of intracerebral hemorrhage. Methods-We analyzed data referring to our prospective population-based registry, including patients with a first-ever stroke followed up to 10 years. Results-In a 5-year period, we included 549 patients (247 men and 302 women; mean age +/- SD, 73.6 +/- 12.5 years) with an intracerebral hemorrhage. The crude annual incidence rate was 36.9 per 100 000 (95% CI, 33.8 to 40.0), 32.9 per 100 000 when standardized to the 2006 European population, and 15.9 per 100 000 when standardized to the world population. The case-fatality rate was 34.6% (95% CI, 30.6 to 38.6) at 7 days; it increased to 50.3% (95% CI, 46.1 to 54.5) at 30 days and to 59.0% (95% CI, 54.9 to 63.1) at 1 year. Diabetes mellitus and posterior fossa hemorrhage were associated with an increased risk of 7- and 30-day mortality, whereas older age was associated with an increased risk of 30- day mortality only. At the Kaplan-Meier analysis, the 10-year survival rate was 24.1% (95% CI, 20.1 to 28.1). Conclusions-Intracerebral hemorrhage is characterized by a severe prognosis, mostly in the short term. Because of the high proportion of fatal events that occurs early after the stroke, it is mandatory to identify and apply specific therapeutic strategies for patients with intracerebral hemorrhage.