Incidence and case fatality of aneurysmal subarachnoid hemorrhage admitted to hospital between 2008 and 2014 in Norway.
Case fatality
Incidence
Subarachnoid hemorrhage
Survival
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
27
02
2020
accepted:
13
06
2020
pubmed:
1
7
2020
medline:
21
1
2021
entrez:
1
7
2020
Statut:
ppublish
Résumé
To provide age- and sex-specific incidence and case fatality rates for non-traumatic aneurysmal subarachnoid hemorrhage (aSAH) in Norway. We also studied time trends in incidence and case fatality, as well as predictors of death following aSAH. A nationwide study using discharge data for patients admitted with aSAH between 2008 and 2014. A total of 1732 patients with aSAH were included. The mean age was 60 years (SD 14) and 63% were females. Crude annual incidence was 5.7 per 100,000 person-years (95% CI 5.4-6.0) and was higher in females (6.3 per 100,000, 95% CI 5.9-6.7) compared with males (4.9 per 100,000, 95% CI 4.5-5.3). The annual decline in aSAH incidence was 3.2% per year (p = 0.007). The cumulative proportions of fatalities at days 30, 90, and 1 year were 22%, 25%, and 37%, respectively. The 30-day mortality rate did not change during the study period. Age (HR 0.7-2.2) and aneurysms in the posterior circulation (HR 1.7, 95% CI 1.3-2.3, p = 0.001) were associated with higher 30-day case fatality following aSAH, while aneurysm repair (HR 0.2, 95% CI 0.2-0.3, p < 0.001) was associated with lower risk. The incidence of aSAH declined in Norway between 2008 and 2014. Case fatality following aSAH continues to be high, and the 30-day mortality during the study period was unchanged. Increasing age and aneurysms in the posterior circulation were associated with increased risk of death within 30 days following aSAH.
Sections du résumé
BACKGROUND
To provide age- and sex-specific incidence and case fatality rates for non-traumatic aneurysmal subarachnoid hemorrhage (aSAH) in Norway. We also studied time trends in incidence and case fatality, as well as predictors of death following aSAH.
METHODS
A nationwide study using discharge data for patients admitted with aSAH between 2008 and 2014.
RESULTS
A total of 1732 patients with aSAH were included. The mean age was 60 years (SD 14) and 63% were females. Crude annual incidence was 5.7 per 100,000 person-years (95% CI 5.4-6.0) and was higher in females (6.3 per 100,000, 95% CI 5.9-6.7) compared with males (4.9 per 100,000, 95% CI 4.5-5.3). The annual decline in aSAH incidence was 3.2% per year (p = 0.007). The cumulative proportions of fatalities at days 30, 90, and 1 year were 22%, 25%, and 37%, respectively. The 30-day mortality rate did not change during the study period. Age (HR 0.7-2.2) and aneurysms in the posterior circulation (HR 1.7, 95% CI 1.3-2.3, p = 0.001) were associated with higher 30-day case fatality following aSAH, while aneurysm repair (HR 0.2, 95% CI 0.2-0.3, p < 0.001) was associated with lower risk.
CONCLUSIONS
The incidence of aSAH declined in Norway between 2008 and 2014. Case fatality following aSAH continues to be high, and the 30-day mortality during the study period was unchanged. Increasing age and aneurysms in the posterior circulation were associated with increased risk of death within 30 days following aSAH.
Identifiants
pubmed: 32601806
doi: 10.1007/s00701-020-04463-x
pii: 10.1007/s00701-020-04463-x
pmc: PMC7415018
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2251-2259Références
Carandang R, Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Kannel WB, Wolf PA (2006) Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA 296:2939–2946. https://doi.org/10.1001/jama.296.24.2939
doi: 10.1001/jama.296.24.2939
pubmed: 17190894
de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ (2007) Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry 78:1365–1372. https://doi.org/10.1136/jnnp.2007.117655
doi: 10.1136/jnnp.2007.117655
pubmed: 17470467
pmcid: 2095631
Donnan GA, Hankey GJ, Davis SM (2010) Intracerebral haemorrhage: a need for more data and new research directions. Lancet Neurol 9:133–134. https://doi.org/10.1016/S1474-4422(10)70001-6
doi: 10.1016/S1474-4422(10)70001-6
pubmed: 20056490
Etminan N, Chang HS, Hackenberg K, de Rooij NK, Vergouwen MDI, Rinkel GJE, Algra A (2019) Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis. JAMA Neurol 76:588–597. https://doi.org/10.1001/jamaneurol.2019.0006
doi: 10.1001/jamaneurol.2019.0006
pubmed: 30659573
pmcid: 6515606
Feigin V, Parag V, Lawes CM, Rodgers A, Suh I, Woodward M, Jamrozik K, Ueshima H, Asia Pacific Cohort Studies C (2005) Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-Pacific region: an overview of 26 cohorts involving 306,620 participants. Stroke 36:1360–1365. https://doi.org/10.1161/01.STR.0000170710.95689.41
doi: 10.1161/01.STR.0000170710.95689.41
pubmed: 15933249
Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V (2009) Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 8:355–369. https://doi.org/10.1016/S1474-4422(09)70025-0
doi: 10.1016/S1474-4422(09)70025-0
pubmed: 19233729
Feigin VL, Norrving B, Mensah GA (2017) Global burden of stroke. Circ Res 120:439–448. https://doi.org/10.1161/CIRCRESAHA.116.308413
doi: 10.1161/CIRCRESAHA.116.308413
pubmed: 28154096
Feigin VL, Rinkel GJ, Lawes CM, Algra A, Bennett DA, van Gijn J, Anderson CS (2005) Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke 36:2773–2780. https://doi.org/10.1161/01.STR.0000190838.02954.e8
doi: 10.1161/01.STR.0000190838.02954.e8
pubmed: 16282541
Garcia-Rodriguez LA, Gaist D, Morton J, Cookson C, Gonzalez-Perez A (2013) Antithrombotic drugs and risk of hemorrhagic stroke in the general population. Neurology 81:566–574. https://doi.org/10.1212/WNL.0b013e31829e6ffa
doi: 10.1212/WNL.0b013e31829e6ffa
pubmed: 23843464
Gonzalez-Perez A, Gaist D, Wallander MA, McFeat G, Garcia-Rodriguez LA (2013) Mortality after hemorrhagic stroke: data from general practice (The Health Improvement Network). Neurology 81:559–565. https://doi.org/10.1212/WNL.0b013e31829e6eff
doi: 10.1212/WNL.0b013e31829e6eff
pubmed: 23843467
Gross BA, Rosalind Lai PM, Frerichs KU, Du R (2014) Aspirin and aneurysmal subarachnoid hemorrhage. World Neurosurg 82:1127–1130. https://doi.org/10.1016/j.wneu.2013.03.072
doi: 10.1016/j.wneu.2013.03.072
pubmed: 23548847
Gulati S, Solheim O, Carlsen SM, Oie LR, Jensberg H, Gulati AM, Madsbu MA, Giannadakis C, Jakola AS, Salvesen O (2018) Risk of intracranial hemorrhage (RICH) in users of oral antithrombotic drugs: nationwide pharmacoepidemiological study. PLoS One 13:e0202575. https://doi.org/10.1371/journal.pone.0202575
doi: 10.1371/journal.pone.0202575
pubmed: 30138389
pmcid: 6107180
Koffijberg H, Buskens E, Granath F, Adami J, Ekbom A, Rinkel GJ, Blomqvist P (2008) Subarachnoid haemorrhage in Sweden 1987-2002: regional incidence and case fatality rates. J Neurol Neurosurg Psychiatry 79:294–299. https://doi.org/10.1136/jnnp.2007.123901
doi: 10.1136/jnnp.2007.123901
pubmed: 17635967
Konczalla J, Brawanski N, Platz J, Senft C, Kashefiolasl S, Seifert V (2016) Aneurysm location as a prognostic outcome factor after subarachnoid hemorrhage (SAH) from ICA- aneurysms: implication for translational research - from bedside to bench?! World Neurosurg. https://doi.org/10.1016/j.wneu.2016.04.086
Korja M, Kaprio J (2016) Controversies in epidemiology of intracranial aneurysms and SAH. Nat Rev Neurol 12:50–55. https://doi.org/10.1038/nrneurol.2015.228
doi: 10.1038/nrneurol.2015.228
pubmed: 26670298
Korja M, Lehto H, Juvela S, Kaprio J (2016) Incidence of subarachnoid hemorrhage is decreasing together with decreasing smoking rates. Neurology 87:1118–1123. https://doi.org/10.1212/WNL.0000000000003091
doi: 10.1212/WNL.0000000000003091
pubmed: 27521438
pmcid: 5027805
Lai L, Morgan MK (2012) Incidence of subarachnoid haemorrhage: an Australian national hospital morbidity database analysis. J Clin Neurosci 19:733–739. https://doi.org/10.1016/j.jocn.2011.09.001
doi: 10.1016/j.jocn.2011.09.001
pubmed: 22326203
Lindbohm JV, Kaprio J, Jousilahti P, Salomaa V, Korja M (2016) Sex, smoking, and risk for subarachnoid hemorrhage. Stroke 47:1975–1981. https://doi.org/10.1161/STROKEAHA.116.012957
doi: 10.1161/STROKEAHA.116.012957
pubmed: 27444257
Lindekleiv H, Sandvei MS, Njolstad I, Lochen ML, Romundstad PR, Vatten L, Ingebrigtsen T, Vik A, Mathiesen EB (2011) Sex differences in risk factors for aneurysmal subarachnoid hemorrhage: a cohort study. Neurology 76:637–643. https://doi.org/10.1212/WNL.0b013e31820c30d3
doi: 10.1212/WNL.0b013e31820c30d3
pubmed: 21321337
Lindekleiv HM, Njolstad I, Ingebrigtsen T, Mathiesen EB (2011) Incidence of aneurysmal subarachnoid hemorrhage in Norway, 1999-2007. Acta Neurol Scand 123:34–40. https://doi.org/10.1111/j.1600-0404.2010.01336.x
doi: 10.1111/j.1600-0404.2010.01336.x
pubmed: 20219020
Lovelock CE, Rinkel GJ, Rothwell PM (2010) Time trends in outcome of subarachnoid hemorrhage: population-based study and systematic review. Neurology 74:1494–1501. https://doi.org/10.1212/WNL.0b013e3181dd42b3
doi: 10.1212/WNL.0b013e3181dd42b3
pubmed: 20375310
pmcid: 2875923
Macdonald RL, Schweizer TA (2017) Spontaneous subarachnoid haemorrhage. Lancet 389:655–666. https://doi.org/10.1016/S0140-6736(16)30668-7
doi: 10.1016/S0140-6736(16)30668-7
Mackey J, Khoury JC, Alwell K, Moomaw CJ, Kissela BM, Flaherty ML, Adeoye O, Woo D, Ferioli S, De Los Rios La Rosa F, Martini S, Khatri P, Broderick JP, Zuccarello M, Kleindorfer D (2016) Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population. Neurology 87:2192–2197. https://doi.org/10.1212/WNL.0000000000003353
doi: 10.1212/WNL.0000000000003353
pubmed: 27770074
pmcid: 5123555
Macpherson KJ, Lewsey JD, Jhund PS, Gillies M, Chalmers JW, Redpath A, Briggs A, Walters M, Langhorne P, Capewell S, McMurray JJ, MacIntyre K (2011) Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986-2005: a retrospective cohort study. BMC Neurol 11:38. https://doi.org/10.1186/1471-2377-11-38
doi: 10.1186/1471-2377-11-38
pubmed: 21447158
pmcid: 3074551
Molyneux AJ, Kerr RS, Birks J, Ramzi N, Yarnold J, Sneade M, Rischmiller J, Collaborators I (2009) Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol 8:427–433. https://doi.org/10.1016/S1474-4422(09)70080-8
doi: 10.1016/S1474-4422(09)70080-8
pubmed: 19329361
pmcid: 2669592
Mukhtar TK, Molyneux AJ, Hall N, Yeates DR, Goldacre R, Sneade M, Clarke A, Goldacre MJ (2016) The falling rates of hospital admission, case fatality, and population-based mortality for subarachnoid hemorrhage in England, 1999–2010. J Neurosurg 1–7. https://doi.org/10.3171/2015.5.jns142115
Nieuwkamp DJ, Rinkel GJ, Silva R, Greebe P, Schokking DA, Ferro JM (2006) Subarachnoid haemorrhage in patients > or = 75 years: clinical course, treatment and outcome. J Neurol Neurosurg Psychiatry 77:933–937. https://doi.org/10.1136/jnnp.2005.084350
doi: 10.1136/jnnp.2005.084350
pubmed: 16638789
pmcid: 2077608
Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ (2009) Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol 8:635–642. https://doi.org/10.1016/S1474-4422(09)70126-7
doi: 10.1016/S1474-4422(09)70126-7
pubmed: 19501022
Nilsson OG, Lindgren A, Stahl N, Brandt L, Saveland H (2000) Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden. J Neurol Neurosurg Psychiatry 69:601–607
doi: 10.1136/jnnp.69.5.601
Norwegian Institute of Public Health Folkehelseinstituttet. http://www.reseptregisteret.no/ . Accessed 13 May 2020
Oie LR, Madsbu MA, Giannadakis C, Vorhaug A, Jensberg H, Salvesen O, Gulati S (2018) Validation of intracranial hemorrhage in the Norwegian Patient Registry. Brain Behav 8:e00900. https://doi.org/10.1002/brb3.900
doi: 10.1002/brb3.900
pubmed: 29484261
pmcid: 5822577
Price AJ, Wright FL, Green J, Balkwill A, Kan SW, Yang TO, Floud S, Kroll ME, Simpson R, Sudlow CLM, Beral V, Reeves GK (2018) Differences in risk factors for 3 types of stroke: UK prospective study and meta-analyses. Neurology 90:e298–e306. https://doi.org/10.1212/WNL.0000000000004856
doi: 10.1212/WNL.0000000000004856
pubmed: 29321237
pmcid: 5798656
Rincon F, Rossenwasser RH, Dumont A (2013) The epidemiology of admissions of nontraumatic subarachnoid hemorrhage in the United States. Neurosurgery 73:217–222; discussion 212-213. https://doi.org/10.1227/01.neu.0000430290.93304.33
doi: 10.1227/01.neu.0000430290.93304.33
pubmed: 23615089
Rinkel GJ, Djibuti M, Algra A, van Gijn J (1998) Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke 29:251–256
doi: 10.1161/01.STR.29.1.251
Rosengart AJ, Schultheiss KE, Tolentino J, Macdonald RL (2007) Prognostic factors for outcome in patients with aneurysmal subarachnoid hemorrhage. Stroke 38:2315–2321. https://doi.org/10.1161/STROKEAHA.107.484360
doi: 10.1161/STROKEAHA.107.484360
pubmed: 17569871
Sandvei MS, Mathiesen EB, Vatten LJ, Muller TB, Lindekleiv H, Ingebrigtsen T, Njolstad I, Wilsgaard T, Lochen ML, Vik A, Romundstad PR (2011) Incidence and mortality of aneurysmal subarachnoid hemorrhage in two Norwegian cohorts, 1984-2007. Neurology 77:1833–1839. https://doi.org/10.1212/WNL.0b013e3182377de3
doi: 10.1212/WNL.0b013e3182377de3
pubmed: 22049205
Sandvei MS, Romundstad PR, Muller TB, Vatten L, Vik A (2009) Risk factors for aneurysmal subarachnoid hemorrhage in a prospective population study: the HUNT study in Norway. Stroke 40:1958–1962. https://doi.org/10.1161/STROKEAHA.108.539544
doi: 10.1161/STROKEAHA.108.539544
pubmed: 19228833
Stegmayr B, Eriksson M, Asplund K (2004) Declining mortality from subarachnoid hemorrhage: changes in incidence and case fatality from 1985 through 2000. Stroke 35:2059–2063. https://doi.org/10.1161/01.STR.0000138451.07853.b6
doi: 10.1161/01.STR.0000138451.07853.b6
pubmed: 15272133
van Gijn J, Kerr RS, Rinkel GJ (2007) Subarachnoid haemorrhage. Lancet 369:306–318. https://doi.org/10.1016/S0140-6736(07)60153-6
doi: 10.1016/S0140-6736(07)60153-6
pubmed: 17258671
Varmdal T, Bakken IJ, Janszky I, Wethal T, Ellekjaer H, Rohweder G, Fjaertoft H, Ebbing M, Bonaa KH (2016) Comparison of the validity of stroke diagnoses in a medical quality register and an administrative health register. Scand J Public Health 44:143–149. https://doi.org/10.1177/1403494815621641
doi: 10.1177/1403494815621641
pubmed: 26660300