title: Cause-specific mortality of 1-year survivors of subarachnoid hemorrhage.
abstract: OBJECTIVE
  To assess long-term, cause-specific mortality rates and rate ratios of the patients alive at 1 year after subarachnoid hemorrhage (SAH).
  
  
  METHODS
  The population-based, prospective, cohort study with a nested case-control design consisted of 64,349 persons (aged 25-74 years at enrollment) who participated in the National FINRISK Study between 1972 and 2007. Four hundred thirty-seven SAH cases, 233 one-year SAH survivors, and their matched intrinsic controls were identified and followed up until the end of 2009 through the nationwide Finnish Causes of Death Register. All-cause mortality rates and rate ratios of the 1-year SAH survivors and controls were the main outcome measures.
  
  
  RESULTS
  Eighty-eight (37.8%) of 233 one-year SAH survivors died during the total follow-up time of 2,487 person-years (median 8.6 years, range 0.1-35.8 years). The 1-year SAH survivors had a hazard ratio of 1.96 (95% confidence interval 1.57-2.47) for death compared with the matched general population with 10 controls for each SAH survivor. One-year SAH survivors had up to 31 additional deaths per 1,000 person-years compared with controls with minimal cerebrovascular risk factors. The higher long-term risk of death among SAH survivors was attributed solely to cerebrovascular diseases, and most important modifiable risk factors for death were smoking, high systolic blood pressure (≥ 159 mm Hg), and high cholesterol levels (≥ 7.07 mmol/L).
  
  
  CONCLUSIONS
  One-year SAH survivors have excess mortality, which is attributed to an exceptional risk of deadly cerebrovascular events. Aggressive post-SAH cerebrovascular risk factor intervention strategies are highly warranted.
authors.affiliation: Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland. miikka.korja@hus.fi
authors.forename: Miikka
authors.initials: M
authors.lastname: Korja
authors.forename: Karri
authors.initials: K
authors.lastname: Silventoinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.forename: Pekka
authors.initials: P
authors.lastname: Jousilahti
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D018672:Community Health Planning; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000401:mortality*; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*