Journal of Korean Neurosurgical Society

  • 제63권1호
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  • Pages.56-68
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  • 2020
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Trends in the Incidence and Treatment of Cerebrovascular Diseases in Korea : Part I. Intracranial Aneurysm, Intracerebral Hemorrhage, and Arteriovenous Malformation

  • Lee, Si Un (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Kim, Tackeun (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Kwon, O-Ki (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Bang, Jae Seung (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Ban, Seung Pil (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Byoun, Hyoung Soo (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Oh, Chang Wan (Department of Neurosurgery, Seoul National University Bundang Hospital)
  • 투고 : 2018.09.04
  • 심사 : 2018.11.11
  • 발행 : 2020.01.01
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초록

Objective : To analyze the incidence and treatment trends of hemorrhagic stroke (HS), according to HS subtypes, using nationwide data in Korea from January 2008 to December 2016. Methods : We used data from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of each disease associated with HS, which included intracranial aneurysm (IA), hypertensive intracerebral hemorrhage (ICH), and arteriovenous malformation (AVM), were calculated and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and number of treatments were analyzed for each cerebrovascular disease using the Korean Classification of Diseases procedure codes. Results : In 2016, the total number of newly diagnosed adult patients with HS was 24169, showing a decrease by 7.0% since 2008; the age-standardized incidence of HS was 46.2 per 100000 person-years. The age-standardized incidence of unruptured IA (UIA) in adults was 71.4 per 100000 person-years-increased by 2.6-fold since 2008-while that of ruptured IA (RIA) was 12.6 per 100000 person-years, which had decreased at a rate of 20.3% since 2008. The number of coil embolization (CE) for UIA increased by 3.4-fold over 9 years and exceeded that of clipping since 2008. With respect to RIA, CE increased by 2.0-fold over 9 years and exceeded that of clipping from 2014. As for spontaneous ICH in adults, the age-standardized incidence was 31.3 per 100000 person-years in 2016-decreased by 34.7% since 2008-and 14.6% of patients diagnosed with ICH were treated in 2016, which was not significantly different from the proportion of patients treated since 2008. The age-standardized incidence of unruptured AVM (UAVM) was 2.0 per 100000 person-year in 2016, while that of ruptured AVM (RAVM) was 2.4 per 100000 person-years in 2016, showing a decreasing rate of 17.2% from 2008. The total number of treated patients with AVM declined since 2014. Conclusion : In Korea, age-related cerebral vascular diseases, such as RIA, ICH, and RAVM, demonstrated a declining trend in age-standardized incidence; meanwhile, UIA and UAVM demonstrated an increased trend in both crude incidence and age-standardized incidence for 9 years. The increase in the elderly population, management of hypertension, and development of diagnostic and endovascular techniques appear to have influenced this trend.

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참고문헌

  1. Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. : Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups: the American academy of neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38 : 1655-1711, 2007 https://doi.org/10.1161/strokeaha.107.181486
  2. Al-Shahi R, Bhattacharya JJ, Currie DG, Papanastassiou V, Ritchie V, Roberts RC, et al. : Prospective, population-based detection of intracranial vascular malformations in adults: the Scottish Intracranial Vascular Malformation Study (SIVMS). Stroke 34 : 1163-1169, 2003 https://doi.org/10.1161/01.str.0000069018.90456.c9
  3. Berman MF, Sciacca RR, Pile-Spellman J, Stapf C, Connolly ES Jr, Mohr JP, et al. : The epidemiology of brain arteriovenous malformations. Neurosurgery 47 : 389-396; discussion 397, 2000 https://doi.org/10.1097/00006123-200008000-00023
  4. Beslow LA, Licht DJ, Smith SE, Storm PB, Heuer GG, Zimmerman RA, et al. : Predictors of outcome in childhood intracerebral hemorrhage: a prospective consecutive cohort study. Stroke 41 : 313-318, 2010 https://doi.org/10.1161/strokeaha.109.568071
  5. Brown RD Jr, Wiebers DO, Torner JC, O'Fallon WM : Incidence and prevalence of intracranial vascular malformations in Olmsted county, Minnesota, 1965 to 1992. Neurology 46 : 949-952, 1996 https://doi.org/10.1212/WNL.46.4.949
  6. Cheng CL, Chien HC, Lee CH, Lin SJ, Yang YH : Validity of in-hospital mortality data among patients with acute myocardial infarction or stroke in National Health Insurance research database in Taiwan. Int J Cardiol 201 : 96-101, 2015 https://doi.org/10.1016/j.ijcard.2015.07.075
  7. Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML : Validation of the National Health Insurance research database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf 20 : 236-242, 2011 https://doi.org/10.1002/pds.2087
  8. Choi JH, Mohr JP : Brain arteriovenous malformations in adults. Lancet Neurol 4 : 299-308, 2005 https://doi.org/10.1016/S1474-4422(05)70073-9
  9. Ding D, Starke RM, Kano H, Mathieu D, Huang P, Kondziolka D, et al. : Radiosurgery for cerebral arteriovenous malformations in a randomized trial of unruptured brain arteriovenous malformations (ARUBA)-eligible patients: a multicenter study. Stroke 47 : 342-349, 2016 https://doi.org/10.1161/STROKEAHA.115.011400
  10. Garg K, Singh PK, Sharma BS, Chandra PS, Suri A, Singh M, et al. : Pediatric intracranial aneurysms--our experience and review of literature. Childs Nerv Syst 30 : 873-883, 2014 https://doi.org/10.1007/s00381-013-2336-9
  11. GBD 2016 Causes of Death Collaborators : Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390 : 1151-1210, 2017 https://doi.org/10.1016/S0140-6736(17)32152-9
  12. Hanley DF, Thompson RE, Muschelli J, Rosenblum M, McBee N, Lane K, et al. : Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial. Lancet Neurol 15 : 1228-1237, 2016 https://doi.org/10.1016/S1474-4422(16)30234-4
  13. Hsieh CY, Chen CH, Li CY, Lai ML : Validating the diagnosis of acute ischemic stroke in a National Health Insurance claims database. J Formos Med Assoc 114 : 254-259, 2015 https://doi.org/10.1016/j.jfma.2013.09.009
  14. Jauch EC, Saver JL, Adams HP Jr, Bruno A, Connors JJ, Demaerschalk BM, et al. : Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44 : 870-947, 2013 https://doi.org/10.1161/STR.0b013e318284056a
  15. Kim H, Sidney S, McCulloch CE, Poon KY, Singh V, Johnston SC, et al. : Racial/Ethnic differences in longitudinal risk of intracranial hemorrhage in brain arteriovenous malformation patients. Stroke 38 : 2430-2437, 2007 https://doi.org/10.1161/strokeaha.107.485573
  16. Koton S, Schneider AL, Rosamond WD, Shahar E, Sang Y, Gottesman RF, et al. : Stroke incidence and mortality trends in US communities, 1987 to 2011. JAMA 312 : 259-268, 2014 https://doi.org/10.1001/jama.2014.7692
  17. Krishnamurthi RV, Feigin VL, Forouzanfar MH, Mensah GA, Connor M, Bennett DA, et al. : Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet Glob Health 1 : e259-e281, 2013 https://doi.org/10.1016/s2214-109x(13)70089-5
  18. Laakso A, Hernesniemi J : Arteriovenous malformations: epidemiology and clinical presentation. Neurosurg Clin N Am 23 : 1-6, 2012 https://doi.org/10.1016/j.nec.2011.09.012
  19. Lackland DT, Roccella EJ, Deutsch AF, Fornage M, George MG, Howard G, et al. : Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association. Stroke 45 : 315-353, 2014 https://doi.org/10.1161/01.str.0000437068.30550.cf
  20. Lee EJ, Lee HJ, Hyun MK, Choi JE, Kim JH, Lee NR, et al. : Rupture rate for patients with untreated unruptured intracranial aneurysms in South Korea during 2006-2009. J Neurosurg 117 : 53-59, 2012 https://doi.org/10.3171/2012.3.JNS111221
  21. Lee JH, Yang DH, Park HS, Cho Y, Jun JE, Park WH, et al. : Incidence of hypertension in Korea: 5-year follow-up study. J Korean Med Sci 26 : 1286-1292, 2011 https://doi.org/10.3346/jkms.2011.26.10.1286
  22. Liang J, Bao Y, Zhang H, Wrede KH, Zhi X, Li M, et al. : The clinical features and treatment of pediatric intracranial aneurysm. Childs Nerv Syst 25 : 317-324, 2009 https://doi.org/10.1007/s00381-008-0725-2
  23. Magro E, Gentric JC, Batista AL, Kotowski M, Chaalala C, Roberge D, et al. : The Treatment of Brain AVMs Study (TOBAS): an all-inclusive framework to integrate clinical care and research. J Neurosurg 128 : 1823-1829, 2018 https://doi.org/10.3171/2017.2.jns162751
  24. Mehrotra A, Nair AP, Das KK, Srivastava A, Sahu RN, Kumar R : Clinical and radiological profiles and outcomes in pediatric patients with intracranial aneurysms. J Neurosurg Pediatr 10 : 340-346, 2012 https://doi.org/10.3171/2012.7.PEDS11455
  25. Mendelow AD, Gregson BA, Rowan EN, Murray GD, Gholkar A, Mitchell PM, et al. : Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet 382 : 397-408, 2013 https://doi.org/10.1016/S0140-6736(13)60986-1
  26. Mould WA, Carhuapoma JR, Muschelli J, Lane K, Morgan TC, McBee NA, et al. : Minimally invasive surgery plus recombinant tissue-type plasminogen activator for intracerebral hemorrhage evacuation decreases perihematomal edema. Stroke 44 : 627-634, 2013 https://doi.org/10.1161/STROKEAHA.111.000411
  27. Osbun JW, Reynolds MR, Barrow DL : Arteriovenous malformations: epidemiology, clinical presentation, and diagnostic evaluation. Handb Clin Neurol 143 : 25-29, 2017 https://doi.org/10.1016/B978-0-444-63640-9.00003-5
  28. Park JK, Kim KS, Kim CB, Lee TY, Lee KS, Lee DH : The accuracy of ICD codes for cerebrovascular diseases in medical insurance claims. Korean J Prev Med 33 : 76-82, 2000
  29. Potts MB, Lau D, Abla AA, Kim H, Young WL, Lawton MT, et al. : Current surgical results with low-grade brain arteriovenous malformations. J Neurosurg 122 : 912-920, 2015 https://doi.org/10.3171/2014.12.JNS14938
  30. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. : 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 49 : e46-e110, 2018 https://doi.org/10.1161/STR.0000000000000158
  31. Rothwell PM, Coull AJ, Giles MF, Howard SC, Silver LE, Bull LM, et al. : Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet 363 : 1925-1933, 2004 https://doi.org/10.1016/S0140-6736(04)16405-2
  32. Sivenius J, Tuomilehto J, Immonen-Raiha P, Kaarisalo M, Sarti C, Torppa J, et al. : Continuous 15-year decrease in incidence and mortality of stroke in Finland: the FINSTROKE study. Stroke 35 : 420-425, 2004 https://doi.org/10.1161/01.str.0000110220.63212.59
  33. Steiner T, Rosand J, Diringer M : Intracerebral hemorrhage associated with oral anticoagulant therapy: current practices and unresolved questions. Stroke 37 : 256-262, 2006 https://doi.org/10.1161/01.STR.0000196989.09900.f8
  34. Teo M, St George J, Lawton MT : Time for BARBADOS after ARUBA trial. Br J Neurosurg 29 : 635-636, 2015 https://doi.org/10.3109/02688697.2015.1096909
  35. Tonetti DA, Gross BA, Atcheson KM, Jankowitz BT, Kano H, Monaco EA 3rd, et al. : The benefit of radiosurgery for ARUBA-eligible arteriovenous malformations: a practical analysis over an appropriate follow-up period. J Neurosurg 128 : 1850-1854, 2018 https://doi.org/10.3171/2017.1.jns162962
  36. Tsai CF, Thomas B, Sudlow CL : Epidemiology of stroke and its subtypes in Chinese vs white populations: a systematic review. Neurology 81 : 264-272, 2013 https://doi.org/10.1212/WNL.0b013e31829bfde3
  37. Wong J, Slomovic A, Ibrahim G, Radovanovic I, Tymianski M : Microsurgery for ARUBA trial (a randomized trial of unruptured brain arteriovenous malformation)-eligible unruptured brain arteriovenous malformations. Stroke 48 : 136-144, 2017 https://doi.org/10.1161/STROKEAHA.116.014660
  38. Xia Z, Wu X, Li J, Liu Z, Chen F, Zhang L, et al. : Minimally invasive surgery is superior to conventional craniotomy in patients with spontaneous supratentorial intracerebral hemorrhage: a systematic review and meta-analysis. World Neurosurg 115 : 266-273, 2018 https://doi.org/10.1016/j.wneu.2018.04.181
  39. Yang W, Caplan JM, Ye X, Wang JY, Braileanu M, Rigamonti D, et al. : Racial associations with hemorrhagic presentation in cerebral arteriovenous malformations. World Neurosurg 84 : 461-469, 2015 https://doi.org/10.1016/j.wneu.2015.03.050

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