Seasonal Variation in Hospitalization and Case Fatality of Subarachnoid Hemorrhage – A Nationwide Danish Study on 9,367 Patients

Fischer, Thomas; Johnsen, Søren Paaske; Pedersen, Lars; Garcı́a-Dorado, David; Sørensen, Henrik Toft; Rothman, Kenneth J.

doi:10.1159/000081047

Cited by 47 publications

(26 citation statements)

References 57 publications

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“…They did not find consistent variation of incidence and case fatality of stroke by month or weekday. The study conducted by Fischer, Johnsen, Pedersen, Gaist, Sorensen and Rothman [31] in Denmark found a modest indication of overall seasonal variation for the risk of hospitalization with this diagnosis. The seasonal pattern, with the highest incidence in January and the nadir in July, was mostly apparent for subjects aged >65 years with little difference by sex.…”

Section: Epidemiology Of Subarachnoid Hemorrhagementioning

confidence: 90%

Epidemiology of Traumatic Brain Injury and Subarachnoid Hemorrhage

et al. 2005

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Incidence rates of traumatic brain injury are high in both industrialized and non-industrialized countries and have been estimated variously to be between 150-250 cases per 100,000 population per year. The estimated incidence rates for subarachnoid hemorrhage (SAH) are between 10 to 25 cases per 100,000 population per year. Seasonal variation in the occurrence of subarachnoid hemorrhage has been reported in studies from different countries, with significant seasonal variations and peak periods for aneurysmal SAH differing widely. A differential racial distribution for SAH has been found as well as a higher mortality rate for women than for men. The cognitive and behavioral consequences of TBI and SAH are significant and affect the quality of life of patients and their families. Recent publications have informed of hypopituitary deficits in patients sustaining TBI or SAH. It is not clear whether the cognitive deficits found in these patients are due to the consequences of the brain injury itself or are related to the hypopituitary deficits. There is a need for research distinguishing the differential cognitive and behavioral effects of the brain injury and the endocrinological deficits in these patients, and for developing adequate treatment.

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Section: Epidemiology Of Subarachnoid Hemorrhagementioning

confidence: 90%

Epidemiology of Traumatic Brain Injury and Subarachnoid Hemorrhage

et al. 2005

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“…Interestingly, there was a modest seasonal variation for hospitalization (peakto-trough ratio = 1.07, 95% CI 1.0-1.12) with the fitted peak in January and the trough in July [25] . In comparison to our study, the ICD codes also include cases of nonaneurysmatic SAH.…”

Section: Discussionmentioning

confidence: 97%

Increased Incidence of Aneurysmal Subarachnoid Hemorrhage on Sundays and Mondays in 1,862 Patients from Eastern Finland

Lindgren¹,

Huttunen²,

Saavalainen³

et al. 2011

Neuroepidemiology

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Background: Temporal patterns of aneurysmal subarachnoid hemorrhage (aSAH) from saccular intracranial aneurysm (sIA) were studied in a consecutive series of 1,862 patients. Methods: Neurosurgery of Kuopio University Hospital (KUH) solely serves a defined catchment population in Eastern Finland. Kuopio’s sIA database contains 1,596 sporadic and 266 familial patients admitted to KUH within 72 h from the onset of aSAH between 1980 and 2007. The distributions by the weekday of the onset of aSAH, admission to KUH, and occlusive therapy of the ruptured sIA were analyzed. Logistic regression was used to search for clinical variables (patients, sIA disease, clinical condition) that would independently correlate with each distribution. Results: The onset of aSAH occurred significantly most often (p < 0.001) on Sundays (n = 330) and Mondays (n = 309) and least frequently on Saturdays (n = 231). None of the clinical variables tested associated significantly and independently with the Sunday and Monday peaks. The admissions to KUH after aSAH were most frequent (p < 0.001) on Mondays (n = 331) and least frequent on Thursdays (n = 221) and Saturdays (n = 221). Overall, 1,655 patients underwent occlusive therapy, most frequently on Mondays (n = 318) and least frequently on Saturdays (n = 189) and Sundays (n = 197). Conclusions: Sundays and Mondays were the most frequent and Saturdays the least frequent days of aSAH in a defined Eastern Finnish population. We could not identify any etiology to this temporal pattern. Binge drinking is frequent in Finland, especially among young males, but age and gender did not correlate with the Sunday and Monday peaks.

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“…On the other hand, strong seasonal variations in the elderly persons have also been reported. At age ≥65 years, Gallerani et al [11] and Fischer et al [12] reported a strong trend toward a peak in the winter at age ≥65 years.…”

Section: Discussionmentioning

confidence: 99%

“…Differences in peak onset of aneurysmal SAH between males and females have been reported by some [3,4,5,6], but other studies have indicated no differences in seasonal variation between males and females. A Danish study [12] on differences in seasonal variation between males and females concluded that there was ‘little difference by sex', with a peak onset in females in October and in males in November. Similar to the results of the present study, there was a slight difference between females and males.…”

Section: Discussionmentioning

confidence: 99%

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

Ishihara

Kunitsugu²,

Nomura³

et al. 2013

Neuroepidemiology

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Background: This study was a cerebral aneurysm registry study conducted in a region with few climatic differences. Based on data collected for over 20 years, seasonal variations and characteristics of subarachnoid hemorrhage (SAH) due to ruptured aneurysms were analyzed. Methods: This study included 5,007 patients in the Yamaguchi Prefecture with aneurysmal SAH between 1986 and 2005. Incidence rates by month, sex, age, severity, and aneurysm site were analyzed. Results: In women, seasonal variation was observed, in particular among those aged ≥50 years. Among those aged 50-69 years, the highest incidence was in October, and the nadir was in June (peak-to-trough ratio = 1.72). At age ≥70 years, this was slightly different, with the highest incidence in December and the nadir in July (peak-to-trough ratio = 1.48). However, there was no seasonal variation in men overall; it was limited to elderly men at age ≥70 years, with the highest incidence in January and the nadir in July (peak-to-trough ratio = 2.9). Aneurysm site and severity showed no relationship with seasonal variation. Conclusion: The present study shows seasonal variations in the onset of SAH. Seasonal variations in SAH differed depending on age and sex.

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Seasonal Variation in Hospitalization and Case Fatality of Subarachnoid Hemorrhage – A Nationwide Danish Study on 9,367 Patients

Cited by 47 publications

References 57 publications

Epidemiology of Traumatic Brain Injury and Subarachnoid Hemorrhage

Epidemiology of Traumatic Brain Injury and Subarachnoid Hemorrhage

Increased Incidence of Aneurysmal Subarachnoid Hemorrhage on Sundays and Mondays in 1,862 Patients from Eastern Finland

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

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