Seasonal Variation in the Incidence of Aneurysmal Subarachnoid Hemorrhage Associated with Age and Gender: 20-Year Results from the Yamaguchi Cerebral Aneurysm Registry

Ishihara, Hideyuki; Kunitsugu, Ichiro; Nomura, Sadahiro; Koizumi, Hiroyasu; Yanagawa, Hiroshi; Shirao, Satoshi; Oka, Fumiaki; Morihiro, Yusuke; Yoshino, Hiroko; Suzuki, Michiyasu

doi:10.1159/000345247

Cited by 13 publications

(4 citation statements)

References 28 publications

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“…We used two control periods for comparison; the immediately preceding 3 months and the same 3 months a year ago, to account for potential seasonal variations that may occur in the presentation of SAH. 22 Study limitations This study's limitations are that while our cohort of centres inform an international, multicentre experience, it is not comprehensive without source data from national databases to account for regional differences in health systems of care. The diagnosis of SAH was obtained using ICD-10 codes in some centres.…”

Section: Discussionmentioning

confidence: 99%

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

et al. 2021

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BackgroundDuring the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study’s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.MethodsWe conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March–31 May 2020. The prior 1-year control period (1 March–31 May 2019) was obtained to account for seasonal variation.FindingsThere was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI −24.3% to −20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170–1035 procedures, respectively, representing an 11.5% (95%CI −13.5% to −9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI −28.0% to −22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile.InterpretationThere was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.

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Section: Discussionmentioning

confidence: 99%

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

et al. 2021

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“…10,13,16,22,32,36 These conflicting results may be explained by referral bias or lack of power due to small sample size in single-center or small regional studies, a limited study period, or variety in study definitions (i.e., mean/ maximum/minimum temperature, temperature difference, season, or wind chill). The evidence on recent infection in relation to the incidence of SAH is limited.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics

Backes¹,

Rinkel²,

Algra

et al. 2016

JNS

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OBJECTIVE This study investigated whether the increased incidence of aneurysmal subarachnoid hemorrhage (SAH) in winter is related to temperature or increased incidence of influenza. Such relationships may elucidate the pathogenesis of intracranial aneurysm rupture. METHODS A nationwide sample of 18,714 patients with SAH was linked with weekly temperature and influenza-like illness consultation data. Poisson regression analyses were used to calculate incidence density ratios (IDRs) with corresponding 95% CIs for the association of SAH incidence with temperature and influenza epidemics; IDRs were adjusted for study year (aIDR). In addition, SAH incidence data from 30 European population-based studies were linked with daily temperature data from the European Climate Assessment. RESULTS The aIDR for SAH during influenza epidemics was 1.061 (95% CI 1.022–1.101) in the univariable and 1.030 (95% CI 0.989–1.074) in the multivariable analysis. This association declined gradually during the weeks after epidemics. Per 1°C temperature drop, the aIDR was 1.005 (95% CI 1.003–1.008) in the univariable and 1.004 (95% CI 1.002–1.007) in the multivariable analysis. In the European population-based studies, the IDR was 1.143 (95% CI 1.129–1.157) per 1°C temperature drop. CONCLUSIONS The incidence of SAH is increased during cold temperatures and epidemic influenza. Future studies with individual patient data are needed to investigate causality between temperature or influenza and SAH.

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“…In the studies from Europe, there might be existing regional differences [4–7]. Seasonal variation, diurnal, and daily factors were also found to be associated with the incidence of nontraumatic subarachnoid hemorrhage [8, 9]. …”

Section: Introductionmentioning

confidence: 99%

Incidence, National Trend, and Outcome of Nontraumatic Subarachnoid Haemorrhage in Taiwan: Initial Lower Mortality, Poor Long-Term Outcome

Lin

Soo

Chen

et al. 2014

BioMed Research International

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To investigate the longitudinal trend of nontraumatic subarachnoid haemorrhage (SAH), we analyzed the annual population-based incidence and mortality rate of nontraumatic subarachnoid hemorrhage in Taiwan. Logistic regression was used to identify independent predictors of mortality. The average incidence rate (IR) of nontraumatic SAH was 6.25 ± 0.88 per 100,000 per year. The prevalence of female patients was higher than in the male population (54.5% versus 45.5%). The average age of these patients was 55.78 ± 17.09 and females were older than males (58.50 ± 15.9 versus 52.45 ± 18.50, P < 0.001). Of these patients, 97.6% (611/626) were treated with surgical intervention with clipping procedure and 2.9% (18/626) with coiling. Total mortality of these patients was 13.4% (84/626). In adjusted analysis, age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.98-0.98; P < 0.001) and Charlson comorbidity index (OR, 0.709; 95% CI, 0.57–0.88; P = 0.002) remained independent predictors of the mortality. Patients with nontraumatic SAH had a much higher prevalence in older age groups and in females than in the general population. Patients with old age and more comorbidity have higher mortality. Aggressive management of patients might reduce the initial mortality; however, patient outcome still remains poor.

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Seasonal Variation in the Incidence of Aneurysmal Subarachnoid Hemorrhage Associated with Age and Gender: 20-Year Results from the Yamaguchi Cerebral Aneurysm Registry

Cited by 13 publications

References 28 publications

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics

Incidence, National Trend, and Outcome of Nontraumatic Subarachnoid Haemorrhage in Taiwan: Initial Lower Mortality, Poor Long-Term Outcome

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