Incidence and Outcomes of Aneurysmal Subarachnoid Hemorrhage : A Multicenter Retrospective Registry-based Descriptive Trial in Kobe City

• Published in: Neurologia medico-chirurgica Vol. 64; no. suppl-1; pp. 519 - 525
• Main Authors: Tsuyoshi OHTA, Shirabe MATSUMOTO, Ryu FUKUMITSU, Hirotoshi IMAMURA, Hidemitsu ADACHI, Yoshie HARA, Kohkichi HOSODA, Hidehito KIMURA, Kazuyuki KUWAYAMA, Takashi MIZOWAKI, Yasuhiko MOTOOKA, Shiro MIYATA, Narihide SHINODA, Yasushi UENO, Ikuya YAMAURA, Yasuhisa YOSHIDA, Chiaki SAKAI, Nobuyuki SAKAI
• Format: Journal Article
• Language: Japanese
• Published: THE JAPAN NEUROSURGICAL SOCIETY 01-04-2024
• ISSN: 0470-8105

[Abstract] The current study aims to evaluate the incidence and results of aneurysmal subarachnoid hemorrhage (aSAH) throughout Kobe City. Based on a multicenter retrospective registry-based descriptive trial involving all 13 primary stroke centers in Kobe City, patients with aSAH treated between October 2017 and September 2019 were studied. A total of 334 patients were included, with an estimated age-adjusted incidence of 11.12 per 100,000 person-years. Curative treatment was given to 94% of patients, with endovascular treatment (51%) preferred over surgical treatment (43%). Of the patients, 12% were treated by shunt surgery for sequential hydrocephalus with a worse outcome at 30 days or discharge (14% vs. 46%, odds ratio (OR): 0.19, 95% confidence interval (CI): 0.088-0.39, p-value <0.001). As for vasospasm and delayed cerebral ischemia, most patients were given intravenous fasudil infusion (73%), with endovascular treatment for vasospasm in 24 cases (7.2%). The fasudil group had more good outcomes (42% vs. 30%, OR: 1.64, 95% CI: 0.95-2.87, p-value=0.075) and significantly less death (3.3% vs. 35%, OR: 0.064, 95% CI: 0.024-0.15, p-value <0.001) at 30 days or discharge. Mortality rose from 12% at 30 days or discharge to 17% at 1 year, but neurological function distribution improved over time (modified Rankin Scale 0-2 was 39% at 30 days or discharge, 53% at 60 days, and 63% at 1 year). Our retrospective registered trial presented various statistics on aSAH, summarizing the current treatment status and prognosis.