Time trends in outcome of subarachnoid hemorrhage

Lovelock, Caroline; Rinkel, Gabriël J.E.; Rothwell, Peter M.

doi:10.1212/wnl.0b013e3181dd42b3

Cited by 419 publications

(249 citation statements)

References 40 publications

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“…Systematic reviews have also found reductions in SAH case-fatality in multiple population-based studies in several countries, 4,12 though few studies have reported case-fatality rates across multiple time periods, and none in the United States. 4 (The Rochester study reported 30-day and 1-year survival stratified by sex and 5-year period, but the overall case-fatality per time period was not reported.)…”

Section: Resultsmentioning

confidence: 99%

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Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population

et al. 2016

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Objective: To characterize temporal trends in subarachnoid hemorrhage (SAH) incidence and outcomes over 5 time periods in a large population-based stroke study in the United States.Methods: All SAHs among residents of the Greater Cincinnati/Northern Kentucky region at least 20 years of age were identified and verified via study physician review in 5 distinct year-long study periods between 1988 and 2010. We abstracted demographics, care patterns, and outcomes, and we compared incidence and case-fatality rates across the study periods.Results: The incidence of SAH in the 5 study periods (age-, race-, and sex-adjusted to the 2000 US population) was 8.8 (95% confidence interval 6.8-10.7), 9.2 (7.2-11.2), 10.0 (8.0-12.0), 9.0 (7.1-10.9), and 7.7 (6.0-9.4) per 100,000, respectively; the trend in incidence rates from 1988 to 2010 was not statistically significant (p 5 0.22). Advanced neurovascular imaging, endovascular coiling, and neurologic intensive care unit availability increased significantly over time. All-cause 5-day (32%-18%, p 5 0.01; for trend), 30-day (46%-25%, p 5 0.001), and 90-day (49%-29%, p 5 0.001) case-fatality rates declined from 1988 to 2010. When we included only proven or highly likely aneurysmal SAH, the declines in case-fatality were no longer statistically significant. Conclusions:Although the incidence of SAH remained stable in this population-based region, 5-day, 30-day, and 90-day case-fatality rates declined significantly. Advances in surgical and medical management, along with systems-based changes such as the emergence of neurocritical care units, are potential explanations for the reduced case-fatality.

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Section: Resultsmentioning

confidence: 99%

“…1,2 Recent studies have reported SAH outcomes over time within the same population, 3,4 but to our knowledge there have been no such recent studies in the United States. We therefore sought to examine temporal trends in nontraumatic SAH incidence, care patterns, and outcomes in a large US region using population-based data.…”

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confidence: 99%

Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population

et al. 2016

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“…47,48 Conflicting conclusions have been reached among patients with SAH and ICH, although trends have probably been favourable. [49][50][51][52][53] There are relatively few corresponding Canadian data. A recent large national study involving more than 13,000 patients who had been resuscitated and hospitalized following cardiac arrest did not detect any improvements in survival rates over time.…”

Section: Discussionmentioning

confidence: 99%

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

Kramer

Zygun

2013

Can J Anesth/J Can Anesth

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“…The patient has a subdural hemorrhage C. The patient has hydrocephalus D. The patient has likely bled from a right posterior communicating aneurysm E. All of the above of survivors with severe disability. 9,10 This overall improvement in outcome is attributed to earlier diagnosis and treatment of ruptured aneurysms, as well as a number of advances in the clinical neurosciences (e.g. neuroimaging technology, endovascular embolization, calcium channel blockers).…”

Section: B a Cmentioning

confidence: 99%

A 72 Year-Old Woman with Sudden Loss of Consciousness

Dmytriw¹,

Pickett²,

Schmidt³

2012

DMJ

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A 72 year-old woman presented to the emergency department of her local hospital, having fallen and struck the left side of her face. She complained of headache and dizziness. One week later, she returned to the emergency department, complaining of diplopia that was initially intermittent, but now constant. An unenhanced CT scan was obtained ( Figure 1A).Five weeks later, she was found at home, unresponsive. She was taken to the emergency department, and an unenhanced CT scan was obtained ( Figure 1B,C). She was intubated and transferred to the Halifax Infirmary. Upon arrival, her Glasgow Coma Scale was 6T: her pupils were weakly reactive and she was withdrawing to painful stimuli, better on the right side than the left side. Her general physical examination was unremarkable.

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Time trends in outcome of subarachnoid hemorrhage

Abstract: Background: Treatment of aneurysmal subarachnoid hemorrhage (SAH) has changed substan-

Cited by 419 publications

References 40 publications

Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population

Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

A 72 Year-Old Woman with Sudden Loss of Consciousness

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