Epidemiology of subarachnoid hemorrhage, patterns of management, and outcomes in China: a hospital-based multicenter prospective study

Abstract

Aims: To conduct a large-scale analysis on epidemiology, management, and outcomes of spontaneous subarachnoid hemorrhage (SAH), and to investigate the current situation of aneurysm obliteration in China.

Methods: A multicenter prospective cohort study involving 132 hospitals throughout China from September 2007 to August 2008 was conducted. A total of 651 patients with spontaneous SAH were evaluated.

Results: The most frequent type of SAH was aneurysmal SAH (77.4%), followed by uncommon causes (17.5%) and uncertain etiologies (5.1%). For aneurysmal SAH, the cumulative mortality at 28 days, 3 months, 6 months, and 12 months was 16.9%, 21.2%, 23.6%, and 24.6%, respectively. Obliteration of aneurysms, age, Hunt and Hess grade, and history of stroke affected the 12-month mortality. In multiple regression analysis, the region, type of hospital, patient's age, history of hypertension, and nonintraventricular hemorrhage impacted aneurysm obliteration.

Conclusion: Aneurysmal rupture is the most common cause of spontaneous SAH in China. The percentage of aneurysm obliteration is still low in China that seems to contribute to long-term mortality. With continued training of specialists, proper allocation of healthcare resources, and establishment of stroke centers, the rate of securing aneurysms is expected to rise.

Conflict of interest statement

The authors declare no conflict of interest.

© 2012 Blackwell Publishing Ltd.

Figures

Figure 1

Flow diagram defining the eligible patients with aneurysmal SAH for surgery treatment.