DOI: 10.1161/01.str.27.4.625. Incidence of Subarachnoid Hemorrhage

10.1161/01.str.27.4.625

Crossref journal-article

Ovid Technologies (Wolters Kluwer Health)

Stroke (276)

Abstract

Background and Purpose The incidence of subarachnoid hemorrhage (SAH) has been estimated for many years at 10 to 15 per 100 000 person-years, but the most recent studies yield lower figures, of 6 to 8 per 100 000 person-years. To investigate the cause of this apparent decline, we studied the influence of year of study, rate of CT, and region. Methods We performed a meta-analysis of SAH incidence studies from 1960 onward and assessed the influence of the three factors by means of univariate and multivariate Poisson regression analyses. Results Eighteen studies fulfilled predefined inclusion criteria. In three Finnish studies, the pooled incidence was 21.4 per 100 000 person-years (95% confidence interval [CI], 19.5 to 23.4); in 15 non-Finnish studies, it was 7.8 per 100 000 person-years (95% CI, 7.2 to 8.4). With univariate analysis, in non-Finnish studies the incidence decreased 0.96% for each percentage point increase of patients investigated with CT (rate ratio, 0.9904; 95% CI, 0.9878 to 0.9930). With 100% CT scanning, the incidence of SAH outside Finland is estimated at 6 per 100 000 person-years. The rate ratio for year of study was 0.952 (95% CI, 0.935 to 0.969) for each later year in the period 1960 to 1994. In multivariate analysis, only the use of CT was independently related to SAH incidence. For the Finnish studies, the rate ratios for use of CT and year of study were not statistically significant. We also found in six studies that incidence for women was 1.6 (95% CI, 1.1 to 2.3) times higher than that for men (7.1 [95% CI, 5.4 to 8.7] and 4.5 [95% CI, 3.1 to 5.8], respectively). Conclusions The actual incidence of SAH has remained stable over the last three decades; the apparent decline in incidence is entirely explained by the greater proportion of patients investigated with CT. The incidence of SAH in Finland is almost three times as high as in other parts of the world.

Bibliography

Linn, F. H. H., Rinkel, G. J. E., Algra, A., & van Gijn, J. (1996). Incidence of Subarachnoid Hemorrhage. Stroke, 27(4), 625â629.

Authors 4

F.H.H. Linn (first)
G.J.E. Rinkel (additional)
A. Algra (additional)
J. van Gijn (additional)

References 46 Referenced 448

Pakarinen S. Incidence aetiology and prognosis of primary subarachnoid hemorrhage. Acta Neurol Scand. 1967;43(suppl 29):1-128. (10.1111/ane.1967.43.s29.29)
Brewis M Poskanzer DC Rolland L Miller H. Neurological disease in an English city. Acta Neurol Scand. 1966;42(suppl 24):1-89.
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Breslow NE Day NE. Statistical Methods in Cancer Research II: The Design and Analysis of Cohort Studies. Lyon France: IARC Scientific Publications; 1987:131-135.
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10.1111/j.1600-0404.1988.tb03677.x
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The WHO MONICA Project, prepared by Pajak A, Kuulasmaa K, Tuomilehto J, Ruokokoski E. Geographical variation in the major risk factors of coronary heart disease in men and women aged 35-64 years. World Health Stat Q. 1988;41:115-140. / World Health Stat Q (1988)
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Rinkel GJE, Wijdicks EFM, Vermeulen M, Ramos LMP, Tanghe HLJ, Hasan D, Meiners LC, van Gijn J. Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. AJNR Am J Neuroradiol. 1991;12:829-834. Concurrent publication in: AJR Am J Roentgenol. 1991;157:1325-1330. / AJNR Am J Neuroradiol (1991)
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10.1212/WNL.44.1.191

Dates

Type	When
Created	14 years, 2 months ago (June 17, 2011, 4:08 p.m.)
Deposited	1 year, 3 months ago (May 12, 2024, 6:35 p.m.)
Indexed	3 days, 21 hours ago (Aug. 23, 2025, 9:25 p.m.)
Issued	29 years, 4 months ago (April 1, 1996)
Published	29 years, 4 months ago (April 1, 1996)
Published Print	29 years, 4 months ago (April 1, 1996)

Funders 0

None

BibTeX

@article{Linn_1996, title={Incidence of Subarachnoid Hemorrhage: Role of Region, Year, and Rate of Computed Tomography: A Meta-Analysis}, volume={27}, ISSN={1524-4628}, url={http://dx.doi.org/10.1161/01.str.27.4.625}, DOI={10.1161/01.str.27.4.625}, number={4}, journal={Stroke}, publisher={Ovid Technologies (Wolters Kluwer Health)}, author={Linn, F.H.H. and Rinkel, G.J.E. and Algra, A. and van Gijn, J.}, year={1996}, month=apr, pages={625–629} }

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