Incidence, case fatality, and functional outcome of intracerebral haemorrhage, according to age, sex, and country income level: a systematic review and meta-analysis
2024

Incidence and Outcomes of Intracerebral Hemorrhage

Sample size: 19470 publication Evidence: high

Author Information

Author(s): Wolsink Axel, Cliteur Maaike P., van Asch Charlotte J., Boogaarts Hieronymus D., Dammers Ruben, Hannink Gerjon, Schreuder Floris H.B.M., Klijn Catharina J.M.

Primary Institution: Radboud University Medical Centre

Hypothesis

The study aimed to update the evidence on incidence, case fatality, and functional outcome of intracerebral hemorrhage (ICH) according to age, sex, and country income level.

Conclusion

The study found a persistently high burden of intracerebral hemorrhage, with a high case fatality and low percentage of patients regaining functional independence.

Supporting Evidence

  • Intracerebral hemorrhage accounts for approximately 28% of all strokes worldwide.
  • The overall crude incidence of ICH was found to be 29.2 per 100,000 person-years.
  • Case fatality at 1 month was 35.5%.
  • Only 31.2% of patients had a good functional outcome after 3-12 months.
  • Incidence was lower in women than in men and increased with age.
  • Incidence was highest in lower-middle income countries.

Takeaway

Intracerebral hemorrhage is a serious type of stroke that affects many people, and most who survive don't fully recover.

Methodology

The study conducted a systematic review and meta-analysis of 70 population-based studies published from 2008 to April 2023.

Potential Biases

Potential bias due to the exclusion of studies with less than 80% of cases confirmed by imaging or autopsy.

Limitations

The majority of studies were from high or upper-middle income countries, and there was considerable heterogeneity among studies.

Participant Demographics

The studies included patients from 26 different countries, with varying income levels.

Statistical Information

Confidence Interval

95% CI 23.3–36.4 for incidence; 95% CI 32.3–38.9 for case fatality; 95% CI 24.7–38.6 for functional outcome.

Digital Object Identifier (DOI)

10.1016/j.lanepe.2024.101180

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