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Neurosurgery:
doi: 10.1227/01.NEU.0000369512.58898.99
Clinical Studies: Editor's Choice

Trends in Case‐Fatality Rates in Hospitalized Nontraumatic Subarachnoid Hemorrhage: Results of a Population‐Based Study in Dijon, France, From 1985 to 2006

Biotti, Damien MD; Jacquin, Agnès MD; Boutarbouch, Mahjouba MD; Bousquet, Olivier MD; Durier, Jérôme PhD; Salem, Douraïeb Ben MD; Ricolfi, Frederic MD; Beaurain, Jacques MD; Osseby, Guy-Victor MD; Moreau, Thibault MD; Giroud, Maurice MD; Béjot, Yannick MD

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Abstract

BACKGROUND: Subarachnoid hemorrhage accounts for 2% to 5% of all strokes and is associated with high morbidity and mortality rates. Reports in the literature show that case-fatality rates vary with time and according to geographical area.

OBJECTIVE: The objective of the study was to evaluate the case-fatality rates in subarachnoid hemorrhage at 1 and 6 months and to determine trends in these rates over 22 years using a population-based registry.

METHODS: The Dijon Stroke Registry has enabled us to perform a comprehensive analysis of subarachnoid hemorrhage diagnosed in a population of >150 000 inhabitants hospitalized between 1985 and 2006 in the Dijon University Hospital, which has both a neurosurgery unit and a neuroradiology unit. Diagnosis was based on clinical and neuroimaging features and, when necessary, on lumbar puncture.

RESULTS: Case-fatality rates for hospitalized subarachnoid hemorrhages at 1 and 6 months were 15.59% (95% confidence interval [CI], 9.37–25.34) and 16.84% (95% CI, 10.33–26.78), respectively. From 1985 to 1995, case-fatality rates for SAH at 1 and 6 months were 17.1% (95% CI, 8.1–34.2) and 17.7% (95% CI, 9.6–31.3), whereas from 1996 to 2006, they were 20.2% (95% CI, 10.2–37.8) and 19.7% (95% CI, 11.1–33.6), respectively.

CONCLUSION: Case-fatality rates for hospitalized subarachnoid hemorrhages in this population-based study remained stable over 22 years, suggesting that this stroke subtype is still a very severe disease despite early management. Most deaths occurred during the first 30 days. Further work is necessary to evaluate levels of prehospital case-fatality in our population-based registry.

Copyright © by the Congress of Neurological Surgeons

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