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

Macpherson, K.J. et al. (2011) Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986 - 2005: a retrospective cohort study. BMC Neurology, 11(1), p. 38. (doi:10.1186/1471-2377-11-38)

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Publisher's URL: http://dx.doi.org/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 Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:MacIntyre, Dr Kate and Langhorne, Professor Peter and Jhund, Dr Pardeep and Briggs, Professor Andrew and Gillies, Dr Michelle and Lewsey, Professor Jim and Capewell, Dr Simon and McMurray, Professor John and Walters, Professor Matthew
Authors: Macpherson, K.J., Lewsey, J.D., Jhund, P.S., Gillies, M., Chalmers, J.W.T., Redpath, A., Briggs, A., Walters, M., Langhorne, P., Capewell, S., McMurray, J.J.V., and MacIntyre, K.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:BMC Neurology
ISSN:1471-2377

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