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Subarachnoid haemorrhage occurrence exhibits a temporal pattern - evidence from meta-analysis
V L Feigin1, C S Anderson, A Rodgers
1Clinical Trials Research Unit, Department of Medicine, Faculty of Health and Medical Sciences, University of Auckland, New Zealand. v.feigin@ctru.auckland.ac.nz
European Journal of Neurology
|September 11, 2002
Summary
Subarachnoid hemorrhage (SAH) risk peaks in late morning and early afternoon. SAH also shows seasonal patterns, occurring more in winter and spring, and daily patterns, with higher incidence on Sundays.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Subarachnoid hemorrhage (SAH) is a critical neurological emergency.
- Understanding temporal patterns of SAH occurrence can inform preventative strategies and resource allocation.
Purpose of the Study:
- To determine the temporal patterns, including diurnal, seasonal, and daily variations, in the occurrence of subarachnoid hemorrhage (SAH).
Main Methods:
- A meta-analysis was conducted using data from population-based incidence studies identified through MEDLINE and EMBASE searches.
- Pooled rate ratios (RR) with 95% confidence intervals (CI) were calculated using the Mantel-Haenszel method.
- Eight studies comprising 2533 first-ever SAH cases were included.
Main Results:
- SAH risk was highest between 6 am and 12 pm (RR=3.19) and 12 pm and 6 pm (RR=2.63).
- Increased risk was observed during winter (RR=1.10) and spring (RR=1.07) compared to summer.
- A higher incidence of SAH occurred on Sundays (RR=1.22) compared to Mondays.
Conclusions:
- Subarachnoid hemorrhage (SAH) exhibits distinct temporal patterns: a diurnal peak in late morning/early afternoon, seasonal peaks in winter/spring, and a daily peak on Sundays.
- These patterns suggest potential common triggering factors influencing acute vascular events.
- Further research into these triggers may aid in the prevention of SAH and other major vascular events.