脳卒中緊急入院症例の院内死亡率―病型別背景因子の比較

In-hospital Mortality in Patient with Acute Ischemic and Hemorrhagic Stroke

はじめに

　厚生労働省の統計¹⁾上，脳卒中は昭和26年から昭和55年までの30年間にわたって日本における死亡原因の1位であった。現在脳卒中の死亡率は過去に比し低下してきているものの，病型によっては依然として比較的高い死亡率を保ち続けている。しかし，脳卒中急性期病院に緊急入院した症例が実際にどの程度入院中に死亡しているのか，また，直接の死亡原因としては何が多いのかについて調べ，病型別に背景因子を比較した報告は少ない。

　今回われわれは，単一施設において1年間に経験した脳卒中症例から死亡例を抽出し，頻度，年齢，死亡原因などの因子について比較検討を行ったので報告する。

Abstract

　There is a lack of evidence to compare in-hospital mortality with different types of stroke.　The purpose of this study was to elucidate the in-hospital mortality after acute ischemic/hemorrhagic stroke and compare the factors associated with the mortality among stroke subtypes.　All patients admitted to Kurashiki Central Hospital in Japan between January 2009 and December 2009, and diagnosed with acute ischemic/hemorrhagic stroke were included in this study.　Demographics and clinical data pertaining to the patients were obtained from their medical records.　Out of 738 patients who had an acute stroke, 53 (7.2%) died in the hospital.　The in-hospital mortality was significantly lower in the cerebral infarction group than in the intracerebral hemorrhage and subarachnoid hemorrhage group (3.5%, 15.1%, and 17.9%, respectively; P＜0.0001).　Age was significantly lower in the subarachnoid hemorrhage group than in the other 2 groups.　With regard to past history, diabetes mellitus was significantly found to be a complication in mortality cases of intracranial hemorrhage.　Further investigation is needed to clarify the effect of diabetes on mortality after intracranial hemorrhage.

(Received: January 6,2011,Accepted: March 1,2011)