Study of Aneurysmal Subarachnoid Hemorrhage in Izumo City, Japan Export

@article{citeulike:3089560, abstract = {Background and Purpose Estimation of the actual incidence rate of subarachnoid hemorrhage and evaluation of the treatment require the inclusion of all patients in a defined geographic area. Methods During 1987 through 1992 in Izumo City, Japan, we estimated the incidence rate of subarachnoid hemorrhage by including dead-on-arrival patients and by further adding the results obtained after reviewing all death certificates registered in this city in the corresponding period. In addition, we compared the management and surgical outcomes in hospitalized patients from 1987 through 1992 with outcomes from 1980 through 1986. Results During 1987 through 1992, we diagnosed 123 patients as having subarachnoid hemorrhage. The crude and the age- and sex-adjusted incidence rates using the 1990 population statistics for Japan were 25 (95\% confidence interval, 21 to 30) per 100 000/y and 23 (95\% confidence interval, 19 to 28) per 100 000/y for all ages, respectively; these occurrences are the highest among those reported to date. Of these patients, 8\% died before receiving medical attention, 27\% in the first week, and 39\% at 1 month. The survival curve for 2 years improved significantly from 1980-1986 to 1987-1992 in patients with admission grades 4 and 5 (P=.035) and in operated patients with preoperative grades 1 through 3 (P=.036). However, there was little improvement in the overall management results (P=.168), possibly because patients with high risk and/or old age were admitted and/or diagnosed more often in the latter period. Conclusions The incidence rate of subarachnoid hemorrhage is much higher than that reported so far in the literature, and despite improvement of management and surgical therapy, the actual case-fatality rate is still high, mainly because of the high mortality rate directly associated with the primary bleeding.}, author = {Inagawa, Tetsuji and Tokuda, Yoshio and Ohbayashi, Naohiko and Takaya, Mikio and Moritake, Kouzo}, citeulike-article-id = {3089560}, citeulike-linkout-0 = {http://stroke.ahajournals.org/cgi/content/abstract/26/5/761}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/7740563}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=7740563}, day = {1}, journal = {Stroke}, keywords = {fatality, incidence, sah}, month = {May}, number = {5}, pages = {761--766}, posted-at = {2008-08-05 21:58:04}, priority = {1}, title = {Study of Aneurysmal Subarachnoid Hemorrhage in Izumo City, Japan}, url = {http://stroke.ahajournals.org/cgi/content/abstract/26/5/761}, volume = {26}, year = {1995} }

TY - JOUR ID - citeulike:3089560 L3 - citeulike-article-id:3089560 N2 - Background and Purpose Estimation of the actual incidence rate of subarachnoid hemorrhage and evaluation of the treatment require the inclusion of all patients in a defined geographic area. Methods During 1987 through 1992 in Izumo City, Japan, we estimated the incidence rate of subarachnoid hemorrhage by including dead-on-arrival patients and by further adding the results obtained after reviewing all death certificates registered in this city in the corresponding period. In addition, we compared the management and surgical outcomes in hospitalized patients from 1987 through 1992 with outcomes from 1980 through 1986. Results During 1987 through 1992, we diagnosed 123 patients as having subarachnoid hemorrhage. The crude and the age- and sex-adjusted incidence rates using the 1990 population statistics for Japan were 25 (95% confidence interval, 21 to 30) per 100 000/y and 23 (95% confidence interval, 19 to 28) per 100 000/y for all ages, respectively; these occurrences are the highest among those reported to date. Of these patients, 8% died before receiving medical attention, 27% in the first week, and 39% at 1 month. The survival curve for 2 years improved significantly from 1980-1986 to 1987-1992 in patients with admission grades 4 and 5 (P=.035) and in operated patients with preoperative grades 1 through 3 (P=.036). However, there was little improvement in the overall management results (P=.168), possibly because patients with high risk and/or old age were admitted and/or diagnosed more often in the latter period. Conclusions The incidence rate of subarachnoid hemorrhage is much higher than that reported so far in the literature, and despite improvement of management and surgical therapy, the actual case-fatality rate is still high, mainly because of the high mortality rate directly associated with the primary bleeding. IS - 5 JF - Stroke EP - 766 TI - Study of Aneurysmal Subarachnoid Hemorrhage in Izumo City, Japan VL - 26 SP - 761 KW - fatality KW - incidence KW - sah AU - Inagawa, Tetsuji AU - Tokuda, Yoshio AU - Ohbayashi, Naohiko AU - Takaya, Mikio AU - Moritake, Kouzo PY - 1995/05/01/ UR - http://stroke.ahajournals.org/cgi/content/abstract/26/5/761 ER -