Artikel
Worldwide trends in aneurysmal subarachnoid haemorrhage incidence in relation to modifiable risk factor prevalence- a systematic review and meta-analysis of population-based studies
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Autoren
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Han-Sol Chang
- Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
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Nima Etminan
- Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
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Katharina Hackenberg
- Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
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Nicolien De Rooij
- University Medical Center Utrecht, Center of Excellence in Rehabilitation Medicine, Utrecht, Niederlande
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Mervyn D. I. Vergouwen
- University Medical Center Utrecht, Center of Excellence in Rehabilitation Medicine, Utrecht, Niederlande
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Gabriel Rinkel
- University Medical Center Utrecht, Neurology and Neurosurgery, Utrecht, Niederlande
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Ale Algra
- University Medical Center Utrecht, Neurology and Neurosurgery, Utrecht, Niederlande; University Medical Center Utrecht, Julius Center, Utrecht, Niederlande
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
Text
Objective: To investigate time trends in the incidence of aneurysmal subarachnoid hemorrhage (SAH) with emphasis on region, age and sexin relation with worldwide prevalence data on risk factors.
Methods: We performed a systematic review of the MEDLINE database until Dez 2016 using the key words ("subarachnoid hemorrhage" OR "subarachnoid haemorrhage") AND ("incidence" OR "epidemiology" OR "population"). Main inclusion criteria were:
- 1.
- prospective study design,
- 2.
- reported study population was representative of the specific population,
- 3.
- reported data included or enabled the calculation of the crude SAH incidence.
We facilitated data on the prevalence of risk factors, such as hypertension and smoking, to investigate for potential association with SAH incidence over time. Poisson regression analyses were performed to calculate crude and continent-specific SAH incidences with 95% confidence intervals (CI) as well as time trends.
Results: We included 84 eligible population-based studies describing a total of 8,176 SAH patients over 67,746,051 person-years (py) in 33 countries. SAH incidences per 100,000 py (incl. 95% CIs) were: Crude 10.3 (9.8-10.7) for 2010 versus 14.3 (13.7-14.9) for 1980, annual decline by 1.1 % (0.9 – 1.3). Europe: 6.2 (5.7-6.7) for 2010 versus 17.8 (16.7-19.1) for 1980, annual decline by 3.5% (3.0-3.9). North America: 5.8 (4.6-7.3) for 2010 versus 8.0 (7.3-8.8) for 1980, annual decline of 1.1% (0.3-1.9). Asia: 13.7 (12.9-14.6) for 2010 versus 26.9 (95% CI:14.7-29.3) for 1980, annual decline by 2.2% (1.8-2.6). Middle/South America: 5.1 (4.3-6.1) for 2010 as well 7.4 (6.0-9.2) for 2010 for Australia, without a significant over time for both last continents. With every mmHg increase in systolic blood pressure, the incidence of SAH increased by 5.1% (4.7-5.4) in the underlying populations.
Conclusion: The SAH incidence has significantly declined over the past 6 decades, with an annual decline by 1.1% worldwide. The crude SAH incidence is estimated 10.3 per 100,000 py for 2010 and is distinctly lower in Europe and distinctly higher in Asia. The time trends in SAH incidence are strongly related to the prevalence of hypertension in the underlying populations.
