title: Mortality after hemorrhagic stroke: data from general practice (The Health Improvement Network).
abstract: OBJECTIVE
  To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database.
  
  
  METHODS
  Thirty-day case fatality was stratified by age, sex, and calendar year after ICH and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year.
  
  
  RESULTS
  Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend < 0.001), and decreased over the period 2000-2001 to 2006-2008 (ICH: from 53.1% to 35.8%, p-trend < 0.001; SAH: from 33.3% to 24.7%, p-trend = 0.02). Risk of death was significantly higher among stroke patients during the first year of follow-up compared with controls (ICH: hazard ratio [HR] 2.60, 95% confidence interval [CI] 2.09-3.24, p < 0.01; SAH: HR 2.87, 95% CI 2.07-3.97, p < 0.01) and remained elevated among survivors at 1 year (ICH: HR 2.02, 95% CI 1.75-2.32, p < 0.01; SAH: HR 1.32, 95% CI 1.02-1.69, p = 0.03).
  
  
  CONCLUSIONS
  More than one-third of individuals die in the first month after hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated risk of death compared with matched individuals from the general population.
authors.affiliation: Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain. lagarcia@ceife.es
authors.forename: Antonio
authors.initials: A
authors.lastname: González-Pérez
authors.forename: David
authors.initials: D
authors.lastname: Gaist
authors.forename: Mari-Ann
authors.initials: MA
authors.lastname: Wallander
authors.forename: Gillian
authors.initials: G
authors.lastname: McFeat
authors.forename: Luis A
authors.initials: LA
authors.lastname: García-Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000401:mortality*; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice / Q000639:trends; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*; D055815:Young Adult