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Socioeconomic Disadvantage Is Associated with a Higher Incidence of Aneurysmal Subarachnoid Hemorrhage


Nichols, L and Stirling, C and Otahal, P and Stankovich, J and Gall, S, Socioeconomic Disadvantage Is Associated with a Higher Incidence of Aneurysmal Subarachnoid Hemorrhage, Journal of stroke and cerebrovascular diseases, 27, (3) pp. 1-9. ISSN 1052-3057 (2017) [Refereed Article]

Copyright Statement

Copyright 2017 National Stroke Association

DOI: doi:10.1016/j.jstrokecerebrovasdis.2017.09.055


Background and Purpose: Aneurysmal subarachnoid hemorrhage (aSAH) incidence is not well studied. Varied definitions of "subarachnoid hemorrhage" have led to a lack of clarity regarding aSAH incidence. The impact of area-level socioeconomic disadvantage and geographical location on the incidence of aSAH also remains unclear. Using a population-based statewide study, we examined the incidence of aSAH in relation to socioeconomic disadvantage and geographical location.

Methods: A retrospective cohort study of nontraumatic subarachnoid hemorrhages from 2010 to 2014 was undertaken. Researchers manually collected data from multiple overlapping sources including statewide administrative databases, individual digital medical records, and death registers. Age-standardized rates (ASRs) per 100,000 person years were calculated using the 2001 Australian population. Differences in incidence rate ratios were calculated by age, sex, area-level socioeconomic status, and geographical location using Poisson regression.

Results: The cohort of 237 cases (mean age, 61.0 years) with a female predominance of 166 (70.04%) included 159 confirmed aSAH, 52 community-based deaths, and 26 probable cases. The ASR for aSAH was 9.99 (95% confidence interval [CI], 8.69-11.29). A significant association between area-level socioeconomic disadvantage and incidence was observed, with the rate of aSAH in disadvantaged geographical areas being 1.40 times higher than that in advantaged areas (95% CI, 1.11-1.82; P = .012).

Conclusion: This study uses a comprehensive search of multiple data sources to define a new baseline of aSAH within an Australian population. This study presents a higher incidence rate of aSAH with socioeconomic variations. As a key risk factor that may explain this paradox, addressing socioeconomic inequalities is important for effective prevention and management interventions.

Item Details

Item Type:Refereed Article
Keywords:Subarachnoid Haemorage, incidence, epidemiology
Research Division:Health Sciences
Research Group:Nursing
Research Field:Acute care
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Nichols, L (Mrs Linda Nichols)
UTAS Author:Stirling, C (Professor Christine Stirling)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Stankovich, J (Dr Jim Stankovich)
UTAS Author:Gall, S (Associate Professor Seana Gall)
ID Code:123695
Year Published:2017
Web of Science® Times Cited:3
Deposited By:Health Sciences
Deposited On:2018-01-19
Last Modified:2018-09-13

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