(Stroke. 2000;31:1843.)
© 2000 American Heart Association, Inc.
Original Contributions |
Epidemiology of Aneurysmal Subarachnoid Hemorrhage in Australia and New Zealand
Incidence and Case Fatality From the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS)
Correspondence to Craig S. Anderson, PhD, Clinical Trials Research Unit, University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail c.anderson{at}ctru.auckland.ac.nz
Background and Purpose—More data on the epidemiology of subarachnoid hemorrhage (SAH) are required to increase our understanding of etiology and prevention. This study sought to determine the incidence and case fatality of SAH from 4 prospective, population-based registers in Australia and New Zealand.
Methods—We identified all cases of "aneurysmal" SAH from November 1995 to June 1998 in Adelaide, Hobart, Perth (Australia), and Auckland (New Zealand), a total population of approximately 2.8 million, using standard diagnostic criteria and uniform community-wide surveillance and data extraction procedures.
Results—A total of 436 cases of SAH were registered, including 432 first-ever events and 4 recurrent events. The mean age of cases was 57 years (range, 16 to 94 years), and 62% were female. From the 400 first-ever events registered over whole years, the crude annual incidence for the total population was 8.1 per 100 000 (95% CI, 7.4, 9.0), with rates higher for females (9.7; 95% CI, 8.6, 11.0) than for males (6.5; 95% CI, 5.5, 7.6). Age-specific rates showed a continuous upward trend with age, although the shape and strength of this association differed between the sexes. Standardized annual incidence of SAH varied across centers, being highest in Auckland largely because of the high rate in Maori and Pacific people. The 28-day case fatality rate for the total population was 39% (95% CI, 34%, 44%), with little variation in ratios across centers.
Conclusions—There is variation in the incidence of SAH in Australia and New Zealand, but the rates are consistently higher for females. A monotonic increase in incidence with age suggests that exposures with cumulative effects and long induction times may be less relevant in the etiology of SAH.
Key Words: Australia • epidemiology • incidence • prognosis • subarachnoid hemorrhage
This article has been cited by other articles:
 |
|
 |
|
  J. B. Bederson, E. S. Connolly Jr, H. H. Batjer, R. G. Dacey, J. E. Dion, M. N. Diringer, J. E. Duldner Jr, R. E. Harbaugh, A. B. Patel, and R. H. Rosenwasser Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association Stroke, March 1, 2009; 40(3): 994 - 1025. [Full Text] [PDF]
|
|
|
|
 |
|
 H Koffijberg, E Buskens, F Granath, J Adami, A Ekbom, G J E Rinkel, and P Blomqvist Subarachnoid haemorrhage in Sweden 1987-2002: regional incidence and case fatality rates J. Neurol. Neurosurg. Psychiatry, March 1, 2008; 79(3): 294 - 299. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N K de Rooij, F H H Linn, J A van der Plas, A Algra, and G J E Rinkel Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends J. Neurol. Neurosurg. Psychiatry, December 1, 2007; 78(12): 1365 - 1372. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D J Nieuwkamp, G J E Rinkel, R Silva, P Greebe, D A Schokking, and J M Ferro Subarachnoid haemorrhage in patients >=75 years: clinical course, treatment and outcome J. Neurol. Neurosurg. Psychiatry, August 1, 2006; 77(8): 933 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Gnecchi-Ruscone Letter Regarding Article by Banki et al, "Acute Neurocardiogenic Injury After Subarachnoid Hemorrhage" Circulation, May 9, 2006; 113(18): e751 - e751. [Full Text] [PDF]
|
|
|
|
|
|
M. J.H. Wermer, P. Greebe, A. Algra, and G. J.E. Rinkel Incidence of Recurrent Subarachnoid Hemorrhage After Clipping for Ruptured Intracranial Aneurysms Stroke, November 1, 2005; 36(11): 2394 - 2399. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Feigin, V. Parag, C. M. M. Lawes, A. Rodgers, I. Suh, M. Woodward, K. Jamrozik, H. Ueshima, and on behalf of the Asia Pacific Cohort Studies Colla Smoking and Elevated Blood Pressure Are the Most Important Risk Factors for Subarachnoid Hemorrhage in the Asia-Pacific Region: An Overview of 26 Cohorts Involving 306 620 Participants Stroke, July 1, 2005; 36(7): 1360 - 1365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y M Ruigrok, G J E Rinkel, C Wijmenga, and J van Gijn Anticipation and phenotype in familial intracranial aneurysms J. Neurol. Neurosurg. Psychiatry, October 1, 2004; 75(10): 1436 - 1442. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Stegmayr, M. Eriksson, and K. Asplund Declining Mortality From Subarachnoid Hemorrhage: Changes in Incidence and Case Fatality From 1985 Through 2000 Stroke, September 1, 2004; 35(9): 2059 - 2063. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Anderson, V. Feigin, D. Bennett, R.-B. Lin, G. Hankey, K. Jamrozik, and for the Australasian Cooperative Research on Subar Active and Passive Smoking and the Risk of Subarachnoid Hemorrhage: An International Population-Based Case-Control Study Stroke, March 1, 2004; 35(3): 633 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Anderson, C. Ni Mhurchu, D. Scott, D. Bennett, K. Jamrozik, and G. Hankey Triggers of Subarachnoid Hemorrhage: Role of Physical Exertion, Smoking, and Alcohol in the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS) Stroke, July 1, 2003; 34(7): 1771 - 1776. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Vogel, R. Verreault, J.-F. Turcotte, M. Kiesmann, and M. Berthel Review Article. Intracerebral Aneurysms: A Review With Special Attention to Geriatric Aspects J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2003; 58(6): M520 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Broderick, C. M. Viscoli, T. Brott, W. N. Kernan, L. M. Brass, E. Feldmann, L. B. Morgenstern, J. L. Wilterdink, and R. I. Horwitz Major Risk Factors for Aneurysmal Subarachnoid Hemorrhage in the Young Are Modifiable Stroke, June 1, 2003; 34(6): 1375 - 1381. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kaminogo, M. Yonekura, and S. Shibata Incidence and Outcome of Multiple Intracranial Aneurysms in a Defined Population Stroke, January 1, 2003; 34(1): 16 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ayala, J. B. Croft, K. J. Greenlund, N. L. Keenan, R. S. Donehoo, A. M. Malarcher, and G. A. Mensah Sex Differences in US Mortality Rates for Stroke and Stroke Subtypes by Race/Ethnicity and Age, 1995-1998 Stroke, May 1, 2002; 33(5): 1197 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. N. Mhurchu, C. Anderson, K. Jamrozik, G. Hankey, D. Dunbabin, W.T. Longstreth Jr, and L. M. Nelson Hormonal Factors and Risk of Aneurysmal Subarachnoid Hemorrhage : An International Population-Based, Case-Control Study Editorial Comment : The Gender Gap in Aneurysmal Subarachnoid Hemorrhage Stroke, March 1, 2001; 32(3): 606 - 612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Feigin, C. S. Anderson, N. E. Anderson, J. B. Broad, M. J. Pledger, and R. Bonita Is There a Temporal Pattern in the Occurrence of Subarachnoid Hemorrhage in the Southern Hemisphere? : Pooled Data From 3 Large, Population-Based Incidence Studies in Australasia, 1981 to 1997 Stroke, March 1, 2001; 32(3): 613 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Hackett and C. S. Anderson Health outcomes 1 year after subarachnoid hemorrhage: An international population-based study Neurology, September 12, 2000; 55(5): 658 - 662. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Kehl, L. Cambj-Sapunar, K. G. Maier, N. Miyata, S. Kametani, H. Okamoto, A. G. Hudetz, M. L. Schulte, D. Zagorac, D. R. Harder, et al. 20-HETE contributes to the acute fall in cerebral blood flow after subarachnoid hemorrhage in the rat Am J Physiol Heart Circ Physiol, April 1, 2002; 282(4): H1556 - H1565. [Abstract] [Full Text] [PDF]
|
|