BACKGROUND Patients with primary intracerebral haemorrhage (ICH) are at increased long-term risks of recurrent stroke and other comorbidities. However, available estimates come predominantly from hospital-based studies with relatively short follow-up. Moreover, there are also uncertainties about the influence of ICH location on risks of recurrent stroke, disability, dementia and quality of life. METHODS In a population-based study (Oxford Vascular Study/2002-2018) of patients with a first ICH with follow-up to 10 years, we determined the long-term risks of recurrent stroke, disability, quality of life, dementia and hospital care costs stratified by haematoma location. RESULTS Of 255 cases with primary ICH (mean/SD age 75.5/13.1), 109 (42.7%) had lobar ICH, 144 (56.5%) non-lobar ICH and 2 (0.8%) had uncertain location. Annual rates of recurrent ICH were higher after lobar versus non-lobar ICH (lobar=4.0%, 2.7-7.2 vs 1.1%, 0.3-2.8; p=0.02). Moreover, cumulative rate of dementia was also higher for lobar versus non-lobar ICH (n/% lobar=20/36.4% vs 16/20.8%, p=0.047), and there was a higher proportion of disability at 5 years in survivors (15/60.0% vs 9/31.0%, p=0.03). The 10-year quality-adjusted life years (QALYs) were also lower after lobar versus non-lobar ICH (2.9 vs 3.8 for non-lobar, p=0.04). Overall, the mean 10-year censor-adjusted costs were £19 292, with over 80% of costs due to inpatient hospital admission costs, which did not vary by haematoma location (p=0.90). CONCLUSION Compared with non-lobar ICH, the substantially higher 10-year risks of recurrent stroke, dementia and lower QALYs after lobar ICH highlight the need for more effective prevention for this patient group.

中文翻译：

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与原发性脑出血发生部位相关的中风，残疾，痴呆和成本复发的十年风险：基于人群的研究。

背景技术原发性脑出血（ICH）患者的中风复发和其他合并症的长期风险增加。但是，可用的估计主要来自基于医院的研究，且随访时间相对较短。此外，ICH位置对复发性中风，残疾，痴呆和生活质量风险的影响也存在不确定性。方法在一项基于人群的研究（Oxford Vascular Study / 2002-2018）中对首例患有ICH且随访10年的患者进行了研究，我们确定了中风复发，残疾，生活质量，痴呆和住院的长期风险根据血肿位置将护理费用分层。结果在255例原发性ICH患者中（平均/标准年龄为75.5 / 13.1），有109例（42.7％）具有大叶ICH，有144例（56.5％）具有非大叶ICH，有2例（0.8％）具有不确定的位置。大叶ICH后复发ICH的年发生率高于非大叶ICH（lobar = 4.0％，2.7-7.2 vs 1.1％，0.3-2.8; p = 0.02）。此外，大叶性痴呆的累积痴呆率也高于非大叶性ICH（n /％大叶= 20 / 36.4％vs 16 / 20.8％，p = 0.047），并且幸存者在5年时的残疾比例更高（15 / 60.0％vs 9 / 31.0％，p = 0.03）。大叶ICH后的10年质量调整生命年（QALYs）也较非大叶ICH低（非大叶ICH为2.9 vs 3.8，p = 0.04）。总体而言，经过审查员调整的10年平均费用为19 292英镑，其中80％以上的费用归因于住院患者的住院费用，但因血肿位置而异（p = 0.90）。结论与非大叶性脑出血相比，复发性中风的10年风险要高得多，