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(Stroke. 1998;29:2298-2303.)
© 1998 American Heart Association, Inc.

Original Contributions

Changes in Subarachnoid Hemorrhage Mortality, Incidence, and Case Fatality in New Zealand Between 1981–1983 and 1991–1993

Thomas Truelsen, MD; Ruth Bonita, MPH, PhD; John Duncan, BA; Neil E. Anderson, MB, ChB; Edward Mee, FRCS

From the University Geriatric Unit, Faculty of Medicine and Health Science, University of Auckland (T.T., R.B., J.D.); the Department of Medicine, Faculty of Medicine and Health Science, University of Auckland, and Department of Neurology, Auckland Hospital (N.E.A.); and the Department of Neurosurgery, Auckland Hospital (E.M.), Auckland, New Zealand; and the ⁴Danish Epidemiology Science Center at the Institute of Preventive Medicine, Copenhagen University Hospital (T.T.), Copenhagen, Denmark.

Correspondence to Associate Professor Ruth Bonita, University Geriatric Unit, North Shore Hospital, Private Bag 93 503, Takapuna, Auckland 9, New Zealand. E-mail r.bonita{at}auckland.ac.nz

Background and Purpose—As with total stroke, mortality rates from subarachnoid hemorrhage (SAH) have declined in New Zealand since the mid-1970s. Data from the Auckland Region Stroke studies allow an understanding of reasons for the change, as SAH incidence and 28-day case fatality rates were measured as part of population-based stroke registers.

Methods—National death registrations were used to describe the trends in mortality rates from SAH (International Classification of Diseases [ICD] code 430) among men and women in New Zealand. Changes in incidence and case fatality rates were determined from 2 large-scale population-based stroke registries carried out in 1981–1983 and 10 years later in Auckland. Similar methodology and case ascertainment techniques were used in both studies.

Results—The mortality rates from SAH declined in both men and women after the mid-1970s. The mortality rate remained higher among women than men. The incidence of SAH was lower in 1991–1993 (11.3 per 100 000) compared with 1981–1983 (14.6 per 100 000). In the younger age groups, the decrease was mostly due to a lower incidence among men, whereas in the older age groups women older than 65 years had a lower incidence. There was no consistent change in case fatality rates between the 2 periods in either men or women.

Conclusions—Mortality rates from SAH have decreased in both men and women. This decrease may be explained by a decrease in the incidence of SAH, because case fatality rates showed no change.

Key Words: cerebrovascular disorders • epidemiology • incidence • mortality • New Zealand • subarachnoid hemorrhage

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