title: Epidemiology of subarachnoid hemorrhage, patterns of management, and outcomes in China: a hospital-based multicenter prospective study.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Li-Heng
authors.initials: LH
authors.lastname: Bian
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Liu
authors.forename: Li Tan
authors.initials: LT
authors.lastname: Nichols
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Gai-Fen
authors.initials: GF
authors.lastname: Liu
authors.forename: Wen-Juan
authors.initials: WJ
authors.lastname: Wang
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome