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Excess Mortality and Cardiovascular Events in Patients Surviving Subarachnoid Hemorrhage A Nationwide Study in Sweden

Nieuwkamp, D. J., Algra, A., Blomqvist, P., Adami, J., Buskens, E., Koffijberg, H. & Rinkel, G. J. E., Apr-2011, In : Stroke. 42, 4, p. 902-907 6 p.

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  • Dennis J. Nieuwkamp
  • Ale Algra
  • Paul Blomqvist
  • Johanna Adami
  • Erik Buskens
  • Hendrik Koffijberg
  • Gabriel J. E. Rinkel

Background and Purpose-Survivors of aneurysmal subarachnoid hemorrhage (SAH) may have an increased risk of cardiovascular events because of shared risk factors. We compared incidences of vascular diseases, vascular death, and all-cause death after SAH with those in the general population.

Methods-From the Swedish Hospital Discharge and Cause of Death registries, we identified patients with SAH between January 1987 and January 2003. Conditional on survival of 3 months after SAH, we calculated standardized mortality and incidence ratios with corresponding 95% CIs for vascular death, all-cause death, and fatal or nonfatal vascular diseases. Cumulative risks were estimated with survival analysis.

Results-Of 17 705 patients with SAH (mean age, 59.7 years; 59.5% women), 11 374 survived at least 3 months after SAH. During follow-up (mean, 6.8 years), 2152 (18.9%) died. The risk of death was 12.9% within 5 years, 23.6% within 10 years, and 35.4% within 15 years after SAH. The overall standardized mortality ratio was 1.57 (95% CI, 1.44 to 1.70) for vascular death and 1.61 (95% CI, 1.52 to 1.70) for all-cause death. The standardized mortality ratios were particularly high in younger individuals, ranging from 2.1 to 3.7 for vascular death and from 2.1 to 2.6 for all-cause death for patients between 50 and 65 years of age. The standardized incidence ratio for fatal or nonfatal vascular diseases was 1.51 (95% CI, 1.45 to 1.56).

Conclusions-Mortality and risk of vascular diseases are increased in survivors of SAH. Prevention of new vascular diseases after SAH by management of risk factors seems important. (Stroke. 2011; 42: 902-907.)

Original languageEnglish
Pages (from-to)902-907
Number of pages6
JournalStroke
Volume42
Issue number4
Publication statusPublished - Apr-2011

    Keywords

  • cardiovascular disease, cerebrovascular disease, epidemiology, mortality, subarachnoid hemorrhage, ACUTE MYOCARDIAL-INFARCTION, LONG-TERM MORTALITY, CASE-FATALITY, HOSPITAL DISCHARGE, HEART-FAILURE, VALIDITY, STROKE, RISK, DIAGNOSIS, ANEURYSMS

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