(Stroke. 1997;28:660-664.)
© 1997 American Heart Association, Inc.
Articles |
Case-Fatality Rates and Functional Outcome After Subarachnoid Hemorrhage
A Systematic Review
From the University Department of Neurology, Utrecht, Netherlands.
Correspondence to Jeannette W. Hop, MD, University Department of Neurology, Hpn G.03.228, PO Box 85500, 3508 GA Utrecht, Netherlands. E-mail j.w.hop{at}neuro.azu.nl.
Background During the last three decades, new management strategies have been developed for patients with aneurysmal subarachnoid hemorrhage. To assess whether the case-fatality rate has improved after the introduction of new management strategies, we studied outcome in all population-based studies from 1960 onward.
Summary of Review To identify population-based studies that reported on case-fatality rate in subarachnoid hemorrhage, we performed a MEDLINE search and checked all reference lists of the studies found. Two authors (J.W.H. and G.J.E.R.) independently assessed all studies for eligibility, using predefined criteria for case finding and diagnosis, and extracted data on case-fatality rates. We used weighted linear regression analysis to quantify change in case-fatality rate over time. We found 21 studies, describing 25 study periods between 1960 and 1992. Case-fatality rates varied between 32% and 67%, with the exception of one recent study. The case-fatality rate decreased by 0.5% per year (95% confidence interval, -0.1 to 1.2); the decline was steeper after adjustment for age and sex (0.9% per year; 95% confidence interval, -0.7 to 2.6; data from 12 studies).
Conclusions The case-fatality rate after subarachnoid hemorrhage has decreased during the last three decades. A plausible explanation for this decrease is the improved management of patients with subarachnoid hemorrhage.
Key Words: morbidity • outcome • subarachnoid hemorrhage
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E. J. Roos, G. J. E. Rinkel, B. K. Velthuis, and A. Algra The relation between aneurysm size and outcome in patients with subarachnoid hemorrhage Neurology, June 27, 2000; 54(12): 2334 - 2336. [Abstract] [Full Text] [PDF]
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T. W M Raaymakers Functional outcome and quality of life after angiography and operation for unruptured intracranial aneurysms J. Neurol. Neurosurg. Psychiatry, May 1, 2000; 68(5): 571 - 576. [Abstract] [Full Text]
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T. Ingall, K. Asplund, M. Mahonen, and R. Bonita A Multinational Comparison of Subarachnoid Hemorrhage Epidemiology in the WHO MONICA Stroke Study Stroke, May 1, 2000; 31(5): 1054 - 1061. [Abstract] [Full Text] [PDF]
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J. M. Wardlaw and P. M. White The detection and management of unruptured intracranial aneurysms Brain, February 1, 2000; 123(2): 205 - 221. [Abstract] [Full Text] [PDF]
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L. Lennihan, S. A. Mayer, M. E. Fink, A. Beckford, M. C. Paik, H. Zhang, Y.-C. Wu, L. M. Klebanoff, E. C. Raps, and R. A. Solomon Effect of Hypervolemic Therapy on Cerebral Blood Flow After Subarachnoid Hemorrhage : A Randomized Controlled Trial Stroke, February 1, 2000; 31(2): 383 - 391. [Abstract] [Full Text] [PDF]
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The Magnetic Resonance Angiography in Relatives of Risks and Benefits of Screening for Intracranial Aneurysms in First-Degree Relatives of Patients with Sporadic Subarachnoid Hemorrhage N. Engl. J. Med., October 28, 1999; 341(18): 1344 - 1350. [Abstract] [Full Text] [PDF]
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S. C. Johnston, D. R. Gress, and J. G. Kahn Which unruptured cerebral aneurysms should be treated?: A cost-utility analysis Neurology, June 1, 1999; 52(9): 1806 - 1806. [Abstract] [Full Text] [PDF]
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 D. J Hellawell, R. Taylor, and B. Pentland Persisting symptoms and carers' views of outcome after subarachnoid haemorrhage Clinical Rehabilitation, April 1, 1999; 13(4): 333 - 340. [Abstract] [PDF]
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F H H Linn, G J E Rinkel, A Algra, and J van Gijn Headache characteristics in subarachnoid haemorrhage and benign thunderclap headache J. Neurol. Neurosurg. Psychiatry, November 1, 1998; 65(5): 791 - 793. [Abstract] [Full Text]
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T. Truelsen, R. Bonita, J. Duncan, N. E. Anderson, and E. Mee Changes in Subarachnoid Hemorrhage Mortality, Incidence, and Case Fatality in New Zealand Between 1981–1983 and 1991–1993 Stroke, November 1, 1998; 29(11): 2298 - 2303. [Abstract] [Full Text] [PDF]
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T. W. M. Raaymakers, G. J. E. Rinkel, M. Limburg, and A. Algra Mortality and Morbidity of Surgery for Unruptured Intracranial Aneurysms : A Meta-Analysis Stroke, August 1, 1998; 29(8): 1531 - 1538. [Abstract] [Full Text] [PDF]
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J. W. Hop, G. J. E. Rinkel, A. Algra, and J. van Gijn Quality of Life in Patients and Partners After Aneurysmal Subarachnoid Hemorrhage Stroke, April 1, 1998; 29(4): 798 - 804. [Abstract] [Full Text] [PDF]
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