Incidence and prognosis of subarachnoid hemorrhage in a Japanese rural community.
Twenty-six first episodes of subarachnoid hemorrhage occurred among 1,621 Hisayama residents aged greater than or equal to 40 years during the 22-year follow-up of a prospective study. Subarachnoid hemorrhage was confirmed by both clinical and autopsy findings. The average annual incidence (96.1/100,000 population) was 3-13 times higher than any previously reported and steeply increased with age in both sexes, being 2.3 times higher for women than for men after adjusting for age. Nine patients (35%) died less than or equal to 8 hours after the onset of subarachnoid hemorrhage. None was correctly diagnosed on the death certificates, and four of the nine (44%) were misdiagnosed as intracerebral hemorrhage. We found the survival rate of patients suffering subarachnoid hemorrhage to be much lower than previously reported because we detected a large number of sudden deaths due to subarachnoid hemorrhage through the high rate of autopsy in our cohort (81.4%).
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Y
Y
Kiyohara
K
K
Ueda
Y
Y
Hasuo
J
J
Wada
H
H
Kawano
I
I
Kato
A
A
Sinkawa
T
T
Ohmura
H
H
Iwamoto
T
T
Omae
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002423:Cause of Death; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012424:Rural Population; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality