title: A population-based study of prognosis of ruptured cerebral aneurysm: mortality and recurrence of subarachnoid hemorrhage.
abstract: OBJECTIVE
  To determine the risk of recurrent subarachnoid hemorrhage (SAH), mortality, and relative survivorship following SAH caused by ruptured cerebral aneurysm (RCA).
  
  
  METHODS
  The 86 individuals with a first diagnosis of SAH caused by RCA in Iceland from 1958 through 1968 were followed a minimum of 24 years (range, 24 to 32.5 years) or until death to determine mortality and to identify those with recurrent SAH.
  
  
  RESULTS
  Thirty-eight patients (44%) died within 30 days of the index event. Two additional (both comatose from onset of ictus) died in the following month. There were no deaths between 3 and 6 months after onset. Based upon the age/gender-specific person years of observation for the population of Iceland, the Standardized Mortality Ratio for the 44 surgically treated patients surviving 6 months was 1.3. Those neurologically normal or with only mild impairment at 6 months had no identified increase in mortality. Excess mortality that was limited to individuals with severe neurologic deficit at 6 months could be identified through the first 10 years after onset. Two 6-month survivors experienced recurrent SAH.
  
  
  CONCLUSIONS
  Early mortality is high (47%) in patients with RCA. In patients operated on for RCA and surviving 6 months, recurrent SAH occurred in 5%. Survivorship among patients surgically treated and neurologically normal or with mild residual neurologic impairment at 6 months following presentation was similar to that expected in the general population. Survivorship among patients surgically treated who had severe residual neurologic impairment at 6 months was significantly reduced.
authors.affiliation: National University Hospital, University of Iceland, Reykjavik.
authors.forename: E
authors.initials: E
authors.lastname: Olafsson
authors.forename: W A
authors.initials: WA
authors.lastname: Hauser
authors.forename: G
authors.initials: G
authors.lastname: Gudmundsson
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000401:mortality* / Q000503:physiopathology*; D002423:Cause of Death; D015331:Cohort Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011379:Prognosis; D012008:Recurrence; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology*; D016019:Survival Analysis