Incidence and outcome of subarachnoid haemorrhage: a retrospective population based study

Objectives-The purpose was to define the incidence and case fatality rates of subarachnoid haemorrhage in the population of Devon and Cornwall. Methods-A retrospective population based design was employed with multiple overlapping methods of case ascertainment. A strict definition of subarachn oid haemorrhage was used. Age and sex specific incidence rates and relative risks for death at different time intervals are calculated. Results-Eight hundred cases of first ever subarachnoid haemorrhage were ide ntified; 77% of cases were verified by CT, 22% by necropsy, and 1% by lumba r puncture. The incidence rates are higher than those previously reported i n the United Kingdom. The age standardised incidence rate (/100 000 person- years) for females was 11.9 (95% confidence interval (95% CI) 9.5-15.0), fo r males 7.4 (5.4-10.0), and the total rate was 9.7 (7.5-12.6), The case fat ality rates at 24 hours, 1 week, and 30 days were 21 (18-24)%, 37 (33-41)%, and 44 (40-49)% respectively. The relative risk for death at 30 days for t hose over 60 years:under 60 years was 2.95 (2.18-3.97). Conclusion-The incidence of subarachnoid haemorrhage in the United Kingdom is higher than previously reported. Three quarters of the mortality occurs within 3 days.