(Stroke. 2001;32:1499.)
© 2001 American Heart Association, Inc.
Original Contributions |
Trends in Incidence and Case Fatality Rates of Aneurysmal Subarachnoid Hemorrhage in Izumo City, Japan, Between 1980–1989 and 1990–1998
From the Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Correspondence to Tetsuji Inagawa, MD, Department of Neurosurgery, Shimane Prefectural Central Hospital, Himebara-cho, Izumo, Shimane 693-8555, Japan. E-mail inagawa{at}spch.izumo.shimane.jp
Background and Purpose—With aging of the population, the profile of subarachnoid hemorrhage (SAH) is likely to change; however, evaluation of long-term trends for incidence and case fatality rates of SAH is still limited.
Methods—We compared the incidence and case fatality rates of aneurysmal SAH during the 9-year period 1990–1998 with those during the 10-year period 1980–1989 in Izumo City, Japan.
Results—During
1980–1989 and 1990–1998, we diagnosed 170 and 188 patients as having
aneurysmal SAH, respectively. The percentage of very elderly
patients aged 
80 years increased from 5% (8 patients) during
1980–1989 to 18% (33 patients) during 1990–1998
(P<0.001). The age-specific
incidence rate of SAH has a tendency to increase with increasing age.
The crude and the age- and sex-adjusted incidence rates using the 1995
population statistics for Japan were 21 and 23 per 100 000/y for all
ages during 1980–1989 and 25 and 23 per 100 000/y during 1990–1998,
respectively. The 3-month case fatality rate of patients aged 
79
years decreased from 38% during 1980–1989 to 26% during 1990–1998
(P=0.021), whereas the case
fatality rates in patients aged 80 years were very high (63% and
79%, respectively) regardless of study periods. Consequently, the
overall case fatality rates for patients with SAH were similar for the
2 study periods (39% and 36%).
Conclusions—The age-
and sex-adjusted incidence rates of aneurysmal SAH were stable
over the 19-year period since 1980 and, despite improvement of outcome
in patients aged 79 years, the overall case fatality rate was not
lower because the improvements were counterbalanced by increasing
numbers of very elderly patients
Key Words: cerebral aneurysm • epidemiology • incidence • Japan • subarachnoid hemorrhage
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