RESIDENCE, AGE AND BLOOD PRESSURES IN THE SURVIVAL WITH CEREBRAL HEMORRHAGE

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Abstract
Keller, A. Z. (VA Central Office, Research Service, DM&S, 15IF, Wash., D.C. 20420). Residence, age and blood pressures in the survival with cerebral hemorrhage. Am J Epidemiol 95: 327–336, 1972.—This study investigates geography, race, age and surgery as factors in survival after cerebral hemorrhage. Comprising the case series are 352 males, who constitute a 5-year 20% sample from veterans' hospitals in the United States. Rates of incidence by age and residence are determined for each race. The frequency of hypertension is presented in relation to race, surgical treatment, performance of angiographic examinations and presence of coma on admission. Cumulative 5-year rates of survival are analyzed for each of these variables and the sites of hemorrhage. The incidence of cerebral hemorrhage is highest among Negro residents of southern states and is quite high among whites from the Mountain States. With advancing age, case incidence increases and survivorship decreases. Survivorship in general is similar for each race by place of residence, age and levels of blood pressure, notwithstanding a marked excess of hypertension among Negroes. The survival rate for hypertensives is essentially half that for normotensives. As expected, the comatose cases are frequently hypertensive and have a correspondingly poor prognosis, while among cases selected by clinicians for angiographic examinations or brain surgery hypertension is relatively infrequent and survivorship is favorable. Of the surgical cases, the ones whose hemorrhages were subdural have a significantly higher 5-year rate of survival than other cases, while cases undergoing no surgery have a slightly better prognosis than cases treated surgically for other intracranial sites of hemorrhage.

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