Advances in Subarachnoid Hemorrhage (original) (raw)
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Smoking and Aneurysmal Subarachnoid Haemorrhage: A Case-Control Study
European Journal of Cardiovascular Prevention & Rehabilitation, 1994
Background Despite recent advances in the management of subarachnoid haemorrhage, the mortality rate associated with the condition remains high. The identification of risk factors for subarachnoid haemorrhage may lead to the development of interventions aimed at its prevention. Methods: We compared the prevalence of vascular risk factors using a case-control design in 141 consecutively admitted patients who had suffered a subarachnoid haemorrhage with that in age-and sex-matched subjects registered with a general practitioner in a western suburb of Lisbon. Results The prevalence of diabetes and hyperlipidaemia did not differ between the groups. Hypertension was 8.3 times more frequent among patients with subarachnoid haemorrhage (95% confidence interval 4.6-1 6.7) than in the control group, and smoking was four times more frequent (95% confidence interval 2.0-8.6). The association between smoking and subarachnoid haemorrhage persisted after controlling for the presence of hypertension (odds ratio for hypertensive participants= 10.5, 95% confidence interval 1.9-56.4; odds ratio for normotensive participants= 3.7, 95% confidence interval 1.6-1 0.1 1 and was independent of both age and sex. Conclusion: These results indicate that hypertension and smoking are both involved in the growth or rupture of cerebral aneurysms.
Stroke, 2012
Background and Purpose— The joint effect of risk factors on the risk of aneurysmal SAH (aSAH) has been studied sparsely. Methods— We examined the potential synergism between cigarette smoking, hypertension, and regular alcohol consumption and the risk of aSAH in a prospective, population-based cohort of participants from the Nord-Trøndelag Health Study and the Tromsø Study in Norway. Interaction was assessed on additive and multiplicative scales. Results— We identified 122 cases of aSAH over 977 895 person-years of follow-up. Interaction was observed between current smoking and hypertension on the additive scale, (relative excess risk because of interaction, 6.40; 95% CI, 0.88–11.92, adjusted for sex and age). We found no significant interaction between hypertension and regular alcohol consumption or current cigarette smoking and regular alcohol consumption on the additive scale. No significant interaction was detected on the multiplicative scale. Conclusions— The joint effect of cu...
Risk Factors for Fatal Subarachnoid Hemorrhage
Stroke, 2003
Background and Purpose— The present study aimed to identify risk factors for mortality due to subarachnoid hemorrhage (SAH) using a comprehensive questionnaire from the Japan Collaborative Cohort (JACC) Study, a Japan-wide population-based prospective study. Methods— A total of 109 293 individuals (45 551 men and 63 742 women, aged 40 to 79 years) free of stroke at entry participated in the JACC Study between 1988 and 1990. Participants were followed up annually until they died or moved away from the surveyed community, or until the end of 1999. A diagnosis of death from SAH was based on the International Classification of Diseases , 10th revision (ICD-10). The age-adjusted univariate and multivariate hazard ratios (HR) and 95% confidence intervals (CI) of various factors were calculated in sex-stratified and sex-specific analyses using the Cox proportional hazards regression model. Results— A total of 244 individuals (88 men and 156 women) died from SAH during the follow-up of 1 08...
A Multinational Comparison of Subarachnoid Hemorrhage Epidemiology in the WHO MONICA Stroke Study
Stroke, 2000
Background and Purpose —By official, mostly unvalidated statistics, mortality from subarachnoid hemorrhage (SAH) show large variations between countries. Using uniform criteria for case ascertainment and diagnosis, a multinational comparison of attack rates and case fatality rates of SAH has been performed within the framework of the WHO MONICA Project. Methods —In 25- to 64-year-old men and women, a total of 3368 SAH events were recorded during 35.9 million person-years of observation in 11 populations in Europe and China. Strict MONICA criteria were used for case ascertainment and diagnosis of stroke subtype. Case fatality was based on follow-up at 28 days after onset. Results —Age-adjusted average annual SAH attack rates varied 10-fold among the 11 populations studied, from 2.0 (95% CI 1.6 to 2.4) per 100 000 population per year in China-Beijing to 22.5 (95% CI 20.9 to 24.1) per 100 000 population per year in Finland. No consistent pattern was observed in the sex ratio of attack ...
Descriptive Characteristics of Subarachnoid Hemorrhage in a Lebanese Sample
Mediterranean Journal of Emergency Medicine & Acute Care, 2021
and region. 1,2 SAH carries disease-specific burdens targeting mainly patients younger than 55 years, leading to permanent disabilities or cognitive impairments, with one-third of SAH patients dying within the first days to weeks post-hemorrhage. 3 This is also reflected on a community level where SAH leads to significant loss of productive lifeyears. 1 The major risk factors for SAH include hypertension, smoking, and heavy alcohol consumption. 4-9 If awake, nearly all patients with SAH report severe headache, typically describing it as the "worst headache in their life". 10 Other patients present with decreased level of consciousness,
Prospective Study on Alcohol Intake and Risk of Subarachnoid Hemorrhage Among Japanese Men and Women
Alcoholism: Clinical and Experimental Research, 2000
Background Few prospective data are available to evaluate potential risk factors of subarachnoid hemorrhage among the Japanese, although several prospective studies conducted in the United States and in Europe have shown a positive relationship between alcohol intake and the risk of subarachnoid hemorrhage. Methods: A 9.4 year follow-up study was conducted on 12,372 men and women age 40 to 69 years who had no history of stroke, in six communities in Japan. The incident cases of subarachnoid hemorrhage were confirmed with computed tomography findings and/or clinical findings. Alcohol intake and other cerebrovascular risk factors were measured at the baseline examination. A Cox proportional hazard analysis was used to estimate the relative risks and 95% confidence intervals of the incidence of subarachnoid hemorrhage. Results: During the follow-up assessment, 71 cases of subarachnoid hemorrhages occurred. For men, heavy drinking appeared to be an independent risk factor for subarachnoid hemorrhage; multivariateadjusted relative risk was 4.3 (95% confidence interval [CI]: 1.1-16.8;~ = 0.04). Among women, no excess risk was found for heavy drinking, probably due to thc small number of heavy drinkers (n = 15). The combination of heavy drinking with smoking or hypertension increased the risk of subarachnoid hemorrhage substantially for men; the multivariate-adjusted relative riskwas 6.0 (95% CI: 1.8-20.1;~ = 0.004) for heavy drinking smokers and 13.0 (95% CI: 3.9-43.9;~ < 0.001) for heavy drinking hypertensivcs. Conclusions: A reduction in alcohol intake, smoking cessation, and control of hypertension are important in preventing subarachnoid hemorrhage among Japanese men.
Neurocritical Care, 2014
Background There is a paucity of reliable and recent data regarding epidemiology of non-aneurysmal subarachnoid hemorrhage (SAH) in population-based studies. Objectives To determine the incidence and case fatality of non-aneurysmal SAH using a population-based design. Methods Medical records and angiographic data of all patients from Stearns and Benton Counties, Minnesota, admitted with SAH were reviewed to identify incident case of non-aneurysmal SAH. Patients with a first-time diagnosis of non-aneurysmal SAH (based on two negative cerebral angiograms performed C7 days apart) between June 1st, 2012 and June 30th, 2014 were considered incident cases. We calculated the incidences of nonaneurysmal and aneurysmal SAH adjusted for age and sex based on the 2010 US census. Results Of the 18 identified SAH among 189,093 resident populations, five were true incident cases of non-aneurysmal SAH in this population-based study. The age-and sexadjusted incidence of non-aneurysmal SAH were 2.8 [95 % confidence interval (CI) 2.7-2Á9] per 100,000 person-years which was lower than aneurysmal SAH incidence of 7.2 [95 % CI 7.1-7.4] per 100,000 person-years. The ageadjusted incidence of non-aneurysmal SAH was similar (compared with aneurysmal SAH) among men; 3.2 [95 % CI 3.1-3.3] per 100,000 person-years versus 2.2 [95 % CI 2.1-2.3] per 100,000 person-years, respectively. The ageadjusted case fatality rate at 3 months was 4.46 and 0.0 per 100,000 persons for aneurysmal and non-aneurysmal SAH, respectively. Conclusions The incidence of non-aneurysmal SAH was higher than previously reported particularly among men.