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 rates in the different populations. The overall 28-day case fatality rate was 42%, with 2-fold differences in age-adjusted rates between populations but little difference between men and women. Case fatality rates were consistently higher in Eastern than in Western Europe. CONCLUSIONS: Using a uniform methodology, the WHO MONICA Project has shown very large variations in attack rates of SAH across 11 populations in Europe and China. The generally accepted view that women have a higher risk of SAH than men does not apply to all populations. Marked differences in outcome of SAH add to the wide gap in the burden of stroke between East and West Europe.
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 rates in the different populations. The overall 28-day case fatality rate was 42%, with 2-fold differences in age-adjusted rates between populations but little difference between men and women. Case fatality rates were consistently higher in Eastern than in Western Europe. CONCLUSIONS: Using a uniform methodology, the WHO MONICA Project has shown very large variations in attack rates of SAH across 11 populations in Europe and China. The generally accepted view that women have a higher risk of SAH than men does not apply to all populations. Marked differences in outcome of SAH add to the wide gap in the burden of stroke between East and West Europe.
Authors: Edward D Greenberg; Y Pierre Gobin; Howard Riina; Carl E Johnson; Apostolos J Tsiouris; Joseph Comunale; Pina C Sanelli Journal: Imaging Med Date: 2011-06-01
Authors: Jacques Sedat; Mustapha Dib; David Rasendrarijao; Denys Fontaine; Michel Lonjon; Philippe Paquis Journal: Neurocrit Care Date: 2005 Impact factor: 3.210
Authors: J Caspers; C Rubbert; B Turowski; D Martens; D C Reichelt; R May; J Aissa; D Hänggi; N Etminan; C Mathys Journal: Clin Neuroradiol Date: 2015-05-05 Impact factor: 3.649
Authors: Bappaditya Ray; Kim L Rickert; Babu G Welch; Jonathan A White; Daniel R Klinger; Benjamin P Boudreaux; Brett A Whittemore; Eugene Gu Journal: Neurocrit Care Date: 2013-10 Impact factor: 3.210
Authors: H Baradaran; V Fodera; D Mir; K Kesavabhotla; K Kesavobhotla; J Ivanidze; U Ozbek; A Gupta; J Claassen; P C Sanelli Journal: AJNR Am J Neuroradiol Date: 2015-05-14 Impact factor: 3.825
Authors: L B J van der Velden; L C Otterspoor; L J Schultze Kool; G J Biessels; F W A Verheugt Journal: Neth Heart J Date: 2009-08 Impact factor: 2.380
Authors: Robert M Starke; Nohra Chalouhi; Muhammad S Ali; Pascal M Jabbour; Stavropoula I Tjoumakaris; L Fernando Gonzalez; Robert H Rosenwasser; Walter J Koch; Aaron S Dumont Journal: Curr Neurovasc Res Date: 2013-08 Impact factor: 1.990