Declining Mortality From Subarachnoid Hemorrhage

Abstract

Background and Purpose-Northern Sweden has one of the highest incidence rates of subarachnoid hemorrhage (SAH) among the populations covered by the WHO MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Project, approximately twice as high as in the other populations in Europe. In this study, trends in incidence, 28-day case fatality (CF), and mortality in SAH were followed over a 16-year period. Methods-Since 1985, all SAHs in northern Sweden among patients 25 to 74 years old have been validated using strict MONICA criteria. From 1985 through 2000, 392 men and 592 women had SAH. During 3 years, 1997 to 1999, SAH among those aged 75 and older were also included. Results-The total incidence among those 25 years and older was 13.3 per 100 000 in men and 24.4 per 100 000 in women.During the 16 years of observation, age standardized incidence in the group aged 25 to 74 years decreased significantly in men (P for trend Ͻ0.0001) but remained essentially unchanged in women (P for trendϭ0.64). The 28-day CF for all years was 36.5% in men, with no significant trend (Pϭ0.7). In women, average CF was 35%, with a significant decline (Pϭ0.003).

Trends in the mortality of non-traumatic subarachnoid hemorrhage in Colombia: a 10-year analysis of a nationwide registry

“…The mortality rate in Colombia was lower than that in countries such as Japan, South Korea, Finland, and northern Sweden. These countries report SAH incidences as high as 27 cases per 100,000 population per year, and mortality rates of 9.5 to 15 deaths per 100,000 population 6,10,11 . In most countries with SAH-related mortality assessments, deaths have been declining or have remained steady for decades, even in countries such as Finland 12,13 , Japan 14 and Sweden…”

“…An understanding of the epidemiology of SAH over time would enable better resource allocation, ensure the appropriate targeting of preventive public health measures, and allow assessment of the effectiveness of existing management strategies 5 . Most published SAH-related epidemiologic studies exclude elderly and pediatric patients and do not analyze genderspecific differences in mortality 6 . In addition, developing countries lack adequate epidemiology estimates of SAH-related mortality.…”

The Effect of Blood Glutamate Scavengers Oxaloacetate and Pyruvate on Neurological Outcome in a Rat Model of Subarachnoid Hemorrhage

“…As many as 30,000 of North Americans suffer from SAH annually, accounting for 5 to 10 % of all stroke cases [1][2][3]. The mortality rate for SAH approaches 45 % at 30 days, and 10 to 15 % of cases are fatal before hospitalization [4][5][6][7]. At the time of the initial bleed, there is a critical reduction in cerebral blood flow as the regional intracranial pressure increases and approaches the systemic arterial pressure.…”

Manejo general en Cuidados Intensivos del paciente con hemorragia subaracnoidea espontánea

“…La incidencia aumenta con la edad, pero la mitad de los pacientes son menores de 55 años cuando presentan el evento 3,5 . La mortalidad se sitúa en alrededor del 50% en estudios poblacionales, con tendencia hacia una mejoría gradual [8][9][10] . La mayoría de las muertes ocurren en las dos primeras semanas del ictus, el 10-15% antes de llegar al hospital y un 25% dentro de las primeras 24 horas del sangrado.…”