The Current State of Non-traumatic Intracranial Hemorrhage Treatment in Japan Using the Diagnosis Procedure Combination Data from 2014

With the introduction of the diagnosis procedure combination (DPC) in Japan, it is now possible to analyze highly specific disease data. In this study, we have analyzed the current state of non-traumatic intracranial hemorrhage (NTICH) by using the DPC data from 2014. From the website of the Ministry of Health, Labour and Welfare, we accessed data from the DPC evaluation subcommittee of the Central Social Insurance Medical Council and examined the current statof treatment of intracranial hemorrhage (ICH) using an aggregation of the NTICH and the Major Diagnostic Category (MDC) 01 database, for each diagnostic group classification in FY2014. In FY2014, 55,378 cases of NTICH were registered, out of which, 36,162 (65.3%) and 19,216 (34.7%cases belonged to Japan Coma Scale (JCS) < 10 (mild group) and JCS ≥ 10 (severe group), respectively. The proportion of elderly people (≥ 80 years old) was 24.6% and 35.1% in the mild and severgroups, respectively, with the proportion being higher in the severe group. In the mild group, conservative and surgical treatments were used for 87.2% and 12.8%, respectively. The mortality rate at discharge was 3.2% in total, 2.6% in the conservative treatment group and 7.5% in the surgical treatmengroup. In the severe group, conservative and surgical treatments were used for 64.6% and 35.4%, respectively. The mortality rate at discharge was 28.9% in total, 35.2% in the conservative treatment group, and 17.4% in the surgical treatment group. In the mild group, 1,959 cases underwent surgicaremoval of the hematoma (5.4% in the mild group), and 74.1%, 12.0%, and 13.9% of these were cranioomies, stereotactic operations, and endoscopic operations, respectively. However, in the severe group, 4,140 cases underwent surgical removal of the hematoma (21.5% in the severe group), and 78.3%, 6.2%, and 15.5% of these were craniotomies, stereotactic operations, and endoscopic operations, respectively. An analysis of the DPC data clarified the current state of cerebral hemorrhage treatment. In particular, in 2014, according to the insurance receipt of endoscopic hematoma removal surgery, the ratio of surgical procedures for hematoma removal was clarified by the DPC data. We believe that DPC data will be an important tool to monitor disease trends.