Incidence and Outcome of Aneurysmal Subarachnoid Hemorrhage

Author:

Schatlo Bawarjan123ORCID,Fung Christian45,Stienen Martin N.6,Fathi Ali R.7,Fandino Javier2ORCID,Smoll Nicolas R.8ORCID,Zumofen Daniel9,Daniel Roy Thomas10,Burkhardt Jan-Karl6,Bervini David4,Marbacher Serge2,Reinert Michael11,D´Alonzo Donato2,Ahlborn Peter12,Mendes Pereira Vitor13,Roethlisberger Michel9,Seule Martin12,Kerkeni Hassen14,Remonda Luca15,Weyerbrock Astrid12,Woernle Kerstin2,Venier Alice11,Perren Fabienne16,Sailer Martin9,Robert Thomas11,Rohde Veit3,Schöni Daniel4,Goldberg Johannes4,Nevzati Edin17ORCID,Diepers Michael15,Gralla Jan18,Z’Graggen Werner18ORCID,Starnoni Daniele10,Woernle Christoph6,Maldaner Nicolai6,Kulcsar Zsolt19,Mostaguir Khaled20,Maduri Rodolfo10,Eisenring Christian4ORCID,Bernays René6,Ferrari Andrea12,Dan-Ura Hiroki2,Finkenstädt Sina6,Gasche Yvan21,Sarrafzadeh Asita1,Jakob Stephan M.22,Corniola Marco1,Baumann Fabian17,Regli Luca6ORCID,Levivier Marc10,Hildebrandt Gerhard12,Landolt Hans2,Mariani Luigi9,Guzman Raphael9,Beck Jürgen45ORCID,Raabe Andreas4,Keller Emanuela23ORCID,Bijlenga Philippe1,Schaller Karl1

Affiliation:

1. Neurosurgery (B.S., A.S., M.C., P.B., K.S.), University Hospital Geneva, Switzerland.

2. Neurosurgery (B.S., J.F., S.M., D.D., K.W., H.D.U., H.L.), Kantonsspital Aarau Switzerland.

3. Neurosurgery, University Hospital Göttingen Germany (B.S., V.R.).

4. Neurosurgery (C.F., D.B., D. Schöni, J. Goldberg, C.E., J.B., A.R.), University Hospital Bern Switzerland.

5. Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, Germany (J.B., C.F.).

6. Neurosurgery (M.N.S., J.-K.B., C.W., N.M., R.B., S.F., L.R.), University Hospital Zürich Switzerland.

7. Neurosurgery, Hirslanden Klinik Aarau Switzerland (A.R.F.).

8. School of Population and Global, University of Melbourne Australia (N.R.S.).

9. Neurosurgery, University Hospital Basel Switzerland (D.Z., M. Roethlisberger, M. Sailer, L.M., R.G.).

10. Neurosurgery, University Hospital Lausanne Switzerland (R.T.D., D. Starnoni, R.M., M.L.).

11. Neurosurgery, Ospedale Civico Lugano Switzerland (M. Reinert, A.V., T.R.).

12. Neurosurgery, Kantonsspital St. Gallen Switzerland (P.A., M. Seule, A.W., A.F., G.H.).

13. Neuroradiology, University of Toronto Canada (V.M.P.).

14. Neurology (H.K.), Kantonsspital Aarau Switzerland.

15. Neuroradiology (L.R., M.D.), Kantonsspital Aarau Switzerland.

16. Neurology (F.P.), University Hospital Geneva, Switzerland.

17. Neurosurgery, Kantonsspital Luzern Switzerland (E.N., F.B.).

18. Neuroradiology (J. Gralla, W.Z.), University Hospital Bern Switzerland.

19. Department of Neuroradiology, University Hospital Zürich, Switzerland (Z.K.).

20. Clinical Research Centre, (K.M.), University Hospital Geneva, Switzerland.

21. Intensive Care Medicine (Y.G.), University Hospital Geneva, Switzerland.

22. Intensive Care Medicine (S.M.J.), University Hospital Bern Switzerland.

23. Intensive Care Medicine (E.K.), University Hospital Zürich Switzerland.

Abstract

Background and Purpose: The purpose of this study was to assess nationwide incidence and outcomes of aneurysmal subarachnoid hemorrhage (aSAH). The Swiss SOS (Swiss Study on Subarachnoid Hemorrhage) was established in 2008 and offers the unique opportunity to provide this data from the point of care on a nationwide level. Methods: All patients with confirmed aneurysmal subarachnoid hemorrhage admitted between January 1, 2009 and December 31, 2014, within Switzerland were recorded in a prospective registry. Incidence rates were calculated based on time-matched population data. Admission parameters and outcomes at discharge and at 1 year were recorded. Results: We recorded data of 1787 consecutive patients. The incidence of aneurysmal subarachnoid hemorrhage in Switzerland was 3.7 per 100 000 persons/y. The number of female patients was 1170 (65.5%). With a follow-up rate of 91.3% at 1 year, 1042 patients (58.8%) led an independent life according to the modified Rankin Scale (0–2). About 1 in 10 patients survived in a dependent state (modified Rankin Scale, 3–5; n=185; 10.4%). Case fatality was 20.1% (n=356) at discharge and 22.1% (n=391) after 1 year. Conclusions: The current incidence of aneurysmal subarachnoid hemorrhage in Switzerland is lower than expected and an indication of a global trend toward decreasing admissions for ruptured intracranial aneurysms. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03245866.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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