Incidence and Risks of Subarachnoid Hemorrhage in China

Abstract

ResultsA total of 226 cases of spontaneous SAH (mean age, 59±13 years; range, 20-87 years; 65% women) were identified among 688 screened, and there were 434 controls (participant characteristics are outlined in Tables I and II in the online-only Data Supplement). Compared with controls, cases were significantly more likely to smoke, have a history of hypertension and stroke, and have an annual income <70 000 Chinese yuan Renminbi (US$11 230).Crude annual incidence (per 100 000) of SAH was 6.2 (95% confidence interval, 5.4-7.0); 4.3 (3.3-5.2) and 8.2 (6.9-9.6) for men and women, respectively (Table 1). Age-and sex-specific rates increased with age; standardized female:male rate ratio was 1.89 (95% confidence interval, 1.44-2.48).Background and Purpose-To determine incidence and risks of subarachnoid hemorrhage in China. Methods-A prospective, population-based, 1:2 matched case-control study in Baotou, Inner Mongolia (≈2 million population) in 2009-2011. Multiple variable models used to determine relative risk and population-attributable risks for exposures. Results-For a total of 226 patients (mean age, 59 years; 65% women; 434 controls), crude annual incidence (per 100 000) of subarachnoid hemorrhage was 6.2 (95% confidence intervals, 5.4-7.0); 4.3 (3.3-5.2) for men and 8.2 (6.9-9.6) for women. Compared with nonsmokers, adjusted relative risk of subarachnoid hemorrhage in current smokers was 2.31 (95% confidence interval, 1.31-4.09) but was 4.00 (1.62-9.89) in women. Population-attributable risk for smoking, hypertension, and low income were 18%, 36% and 59%, respectively. Conclusions-The incidence of subarachnoid hemorrhage in China is slightly lower than in Western countries and is related to smoking, hypertension, and poor socioeconomic status. (Stroke. 2013;44:2891-2893.)

Epidemiological Features of Nontraumatic Spontaneous Subarachnoid Hemorrhage in China

“…[511] Our cohort is consistent with this feature. Older patients with hypertension appeared to be more susceptible to aneurysmal SAH.…”

“…[9101112] The development of both diagnostic modalities and emergent rescuing capabilities is the most important contributor to this discrepancy. This study is based on nationwide data collected from 32 major neurosurgical centers and represents the largest hospital-based epidemiological analysis of SAH in China.…”

Determining rural risk for aneurysmal subarachnoid hemorrhages: A structural equation modeling approach

“…[5,6] Differential health outcomes and increased mortality rates are suggested to be associated with a range of influences including lower socioeconomic status, impaired access to care, and poorer rural risk factor profiles. [7] As a cerebrovascular event aSAH has been extensively linked to a number of modifiable risk factors including smoking and excessive alcohol consumption [8,9] as well as increased risk-taking and the higher prevalence of modifiable risk factors. [10,11] There has been a limited analysis of the complex phenomenon that is the cumulative impact and multiplicity of risk factors associated with rurality and outcome following an aSAH.…”

Alcohol consumption and risk of subarachnoid hemorrhage: A meta-analysis of 14 observational studies

“…Two studies were excluded as they only investigated alcohol consumption within 24 h and one week before SAH, which was not representative of habitual alcohol consumption ( 46 , 47 ). Ten studies ( 48 – 57 ) that lacked sufficient data calculating RR estimates, and eight studies ( 58 – 65 ) where alcohol consumption had not been quantified were excluded. The remaining three studies reported on the same population ( 66 – 68 ).…”