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Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986 - 2005: A retrospective cohort study

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Macpherson, KJ and Lewsey, JD and Jhund, PS and Gillies, M and Chalmers, JWT and Redpath, A and Briggs, A and Walters, M and Langhorne, P and Capewell, S and McMurray, JJV and Macintyre, K, Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986 - 2005: A retrospective cohort study, BMC Neurology, 11 Article 38. ISSN 1471-2377 (2011) [Refereed Article]


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Licensed under Creative Commons Attribution 2.0 Generic (CC BY 2.0) http://creativecommons.org/licenses/by/2.0/

DOI: doi:10.1186/1471-2377-11-38

Abstract

BACKGROUND: To examine age and sex specific incidence and 30 day case fatality for subarachnoid haemorrhage (SAH) in Scotland over a 20 year period.

METHODS: A retrospective cohort study using routine hospital discharge data linked to death records.

RESULTS: Between 1986 and 2005, 12,056 individuals experienced an incident SAH. Of these 10,113 (84%) survived to reach hospital. Overall age-standardised incidence rates were greater in women than men and remained relatively stable over the study period. In 2005, incidence in women was 12.8 (95% CI 11.5 to 14.2) and in men 7.9 (95% CI 6.9 to 9.1). 30 day case fatality in individuals hospitalised with SAH declined substantially, falling from 30.0% in men and 33.9% in women in 1986-1990 to 24.5% in men and 29.1% in women in 2001-2005. For both men and women, the largest reductions were observed in those aged between 40 to 59 years. After adjustment for age, socio-economic status and co-morbidity, the odds of death at 30 days in 2005 compared to odds of death in 1986 was 0.64 (0.54 to 0.76), p < 0.001 for those below 70 years, and 1.14 (0.83 to 1.56), p = 0.4 in those 70 years and above.

CONCLUSIONS: Incidence rates for SAH remained stable between 1986 and 2005 suggesting that a better understanding of SAH risk factors and their reduction is needed. 30 day case fatality rates have declined substantially, particularly in middle-age. However, they remain high and it is important to ensure that this is not due to under-diagnosis or under-treatment.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Macintyre, K (Dr Kate Macintyre)
ID Code:95675
Year Published:2011
Web of Science® Times Cited:6
Deposited By:Medicine (Discipline)
Deposited On:2014-10-07
Last Modified:2017-11-03
Downloads:427 View Download Statistics

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