Cause-specific mortality of 1-year survivors of subarachnoid hemorrhage

被引:76
作者
Korja, Miikka [1 ]
Silventoinen, Karri [2 ]
Laatikainen, Tiina [3 ,5 ,6 ]
Jousilahti, Pekka [3 ]
Salomaa, Veikko [3 ]
Kaprio, Jaakko [4 ,7 ,8 ]
机构
[1] Univ Helsinki, Cent Hosp, Dept Neurosurg, Helsinki, Finland
[2] Univ Helsinki, Dept Social Res, Populat Res Unit, Helsinki, Finland
[3] Natl Inst Hlth & Welf, Dept Chron Dis Prevent, Helsinki, Finland
[4] Natl Inst Hlth & Welf, Dept Mental Hlth & Subst Abuse Serv, Helsinki, Finland
[5] Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland
[6] Hosp Dist N Karelia, Joensuu, Finland
[7] Univ Helsinki, Dept Publ Hlth, Helsinki, Finland
[8] Inst Mol Med FIMM, Helsinki, Finland
基金
芬兰科学院;
关键词
HOSPITAL DISCHARGE REGISTER; TERM EXCESS MORTALITY; RISK-FACTORS; POPULATION; VALIDATION; FINLAND; DEATH;
D O I
10.1212/WNL.0b013e31827f0fb5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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-termrisk 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). Conclusion: 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. Neurology (R) 2013;80:481-486
引用
收藏
页码:481 / 486
页数:6
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