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Evidence for excess long-term mortality after treated subarachnoid hemorrhage
A Ronkainen1, M Niskanen, J Rinne
1Department of Neurosurgery, University Hospital of Kuopio, Kuopio, Finland. antti.ronkainen@kuh.fi
Stroke
|December 12, 2001
Summary
Patients with aneurysmal subarachnoid hemorrhage (SAH) face higher long-term mortality rates than the general population. This increased risk, particularly in younger individuals, highlights the need for ongoing management of vascular risk factors post-treatment.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) is a critical neurological event.
- Long-term survival data post-treatment for SAH is crucial for patient management.
Purpose of the Study:
- To compare the long-term mortality of aneurysmal subarachnoid hemorrhage (SAH) patients with the general population.
- To identify factors influencing excess mortality in SAH survivors.
Main Methods:
- Retrospective analysis of 1537 patients treated for ruptured aneurysms (1977-1998).
- Follow-up for a median of 7.5 years to determine mortality.
- Calculation of standardized mortality ratios based on age, sex, and functional outcome (Glasgow Outcome Scale).
Main Results:
- SAH survivors with good recovery at 12 months had double the mortality rate of the general population.
- Excess mortality was most pronounced in younger age groups.
- Cerebrovascular and cardiovascular diseases were primary causes of premature death, irrespective of pre-existing conditions.
Conclusions:
- Aneurysmal SAH survivors experience elevated long-term mortality.
- SAH should be considered part of a chronic vascular disease process.
- Emphasis on risk factor management and long-term follow-up is essential for SAH patients.