脳卒中データバンクを利用したくも膜下出血の解析 : 発症年齢, 性差, 予後における全国・地域別の検討  [in Japanese] Analysis of Subarachnoid Hemorrhage by Using the Japanese Stroke Data Bank : National and Regional Investigation on Age, Gender, and Prognosis of Subarachnoid Hemorrhage  [in Japanese]

We explored national and regional characteristics based on age, gender, and prognosis of subarachnoid hemorrhage by using the Japanese Stroke Data Bank, a data bank of acute stroke patients established to provide evidence for standardization of Japanese stroke management. We analyzed data from 1,183 patients with subarachnoid hemorrhage in the Japanese Stroke Data Bank. For regional investigation, we divided the patients into 3 groups according to their place of residence : Hokkaido, Tohoku, and the area west of Kanto. The total male-to-female ratio was 1:1.88. The female proportion was dominant in older patients : 1:2.27 in the 60s, 1:4.48 in the 70s, and 1:4.63 in the 80s. The age distribution of the patients was apparently different between male and female. Female patients (mean age : 64.5) were older than male patients (mean age : 56.1) (p<0.0001). In the regional analysis based on age, the patients of the area west of Kanto were older than those of Hokkaido and Tohoku (p<0.001). Prognosis was evaluated by the modified Rankin scale (mRS). In total, favorable outcome (mRS of 0-2), extremely poor outcome (mRS of 5-6), and death (mRS of 6) were 58.0%, 28.3%, and 19.8%, respectively. In a regional analysis, the outcome of the patients of the area west of Kanto was poorer than that of Hokkaido and Tohoku (p<0.001). Since the World Federation of Neurological Surgeons scale did not differ among the patients of the 3 groups, we speculate that the higher number of aged patients may be related to the higher number of patients having a poor prognosis in the area west of Kanto.