gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Incidence, therapy and outcome of aneurysmal subarachnoid hemorrhage – The Swiss study on aneurysmal subarachnoid hemorrhage (Swiss SOS)

Meeting Abstract

  • Bawarjan Schatlo - Department of Neurosurgery/Centre de Recherche Clinique/Department of Neuroradiology, Faculté de Médecine de Genève, Geneva University Hospital, Switzerland; Klinik für Neurochirurgie, Kantonsspital Aarau, Switzerland; Klinik für Neurochirurgie, Georg-August-Universität, Universitätsmedizin Göttingen, Germany
  • Christian Fung - Klinik für Neurochirurgie, Inselspital, Bern, Switzerland
  • Martin Stienen - Department of Neurosurgery/Centre de Recherche Clinique/Department of Neuroradiology, Faculté de Médecine de Genève, Geneva University Hospital, Switzerland; Klinik für Neurochirurgie, Kantonsspital St. Gallen, Switzerland
  • Ali-Reza Fathi - Klinik für Neurochirurgie, Kantonsspital Aarau, Switzerland
  • Philippe Bijlenga - Department of Neurosurgery/Centre de Recherche Clinique/Department of Neuroradiology, Faculté de Médecine de Genève, Geneva University Hospital, Switzerland
  • Karl Schaller - Department of Neurosurgery/Centre de Recherche Clinique/Department of Neuroradiology, Faculté de Médecine de Genève, Geneva University Hospital, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.02.04

doi: 10.3205/16dgnc004, urn:nbn:de:0183-16dgnc0046

Veröffentlicht: 8. Juni 2016

© 2016 Schatlo et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) accounts for a large proportion of productive life years lost to stroke. Its management requires a multidisciplinary effort. Much of the presently available data on incidence, treatment and outcomes comes from studies with a strong selection bias, studies confounding all kinds of SAH, i.e. aneurysmal and non-aneurysmal, cohorts of single centers or retrospective series. The aim of this study is to assess incidence, treatment modalities and outcomes after SAH from a prospective national registry.

Method: Patients admitted with aSAH across Switzerland are included starting January 1st 2009. All eight Swiss hospitals providing neurovascular care for aSAH patients participated in the registry. Admission parameters, treatment and outcomes at discharge and one year were recorded. Incidence was calculated after WHO-standardization, age-stratification and based on population data from the Swiss Federal Bureau of Statistics.

Results: From 2009 to 2013, 1580 patients were recorded in the Swiss SOS database. The annual incidence of aSAH in the observation period ranged from 3.56 to 3.95/100,000/year. Its peak of 7.6/100,000/year was reached in the age group 55-59 years. 86% of patients arrived at a tertiary neurovascular care center on the same or within one day of symptom occurrence. The ratio of female to male patients was 2:1. Median age at aSAH was 55 years. Good grade aSAH (World federation of neurosurgical societies (WFNS) grades 1&2) accounted for more 38% and 18% of cases respectively. WFNS grades 3, 4 and 5 made up 7%, 10% and 26% respectively. Fisher grades 1 and 2 accounted for 14% of cases while 86% were Fisher grades 3 and 4. Surgical aneurysm occlusion was performed in 36% and endovascular occlusion in 48% of cases. After a mean length of stay of 20 days, 51% of patients were discharged with good outcome (mRankin <3) and 30% with poor outcome (mRankin 3-5). In-hospital mortality was 19%. At one year, good outcome ranged at 68%.

Conclusions: The results of this first national database on subarachnoid hemorrhage reflect the current standard of care. Annual incidence of aSAH in Switzerland is at the lower end with 3.46 to 3.95/100,000. Our series confirms a current trends towards lower mortality and higher employment of endovascular aneurysm repair compared to historical series.