Abstract 10857: Long-term Cause-specific Mortality of One-year Survivors of Subarachnoid Haemorrhage - A Population-based Prospective Study

Abstract

Objective: To assess long-term cause-specific and total mortality, and risk factors for death, among the patients alive at one year after an acute subarachnoid haemorrhage (SAH) episode.

Methods: A population-based prospective cohort study with a nested case-control design. 437 SAH cases, and 233 one-year SAH survivors, and their matched intrinsic controls (10 controls for each case) were identified amongst the 64 349 persons (25-74 years old at enrolment), who participated in the National FINRISK Study between 1972 and 2002 in Finland, and were followed up until the end of 2009 through the nationwide Causes of Death Register.

Results 88 (37.8%) out of 233 one-year SAH survivors died during the total follow-up time of 2487 person-years (median 8.6 years, range 0.1 to 35.8 years). The one-year SAH survivors had a hazard ratio of 1.96 (95% confidence interval 1.57 to 2.47) for death compared with the general population controls. The higher long-term risk of death among the SAH survivors was attributed solely to cerebrovascular diseases. Among the SAH survivors, 28% of the deaths were due to cerebrovascular causes, compared to 8% among general population. Most important modifiable risk factors for death were smoking, high systolic blood pressure (≥ 159 mmHg) and high cholesterol levels (≥ 7.07 mmol/l).

Conclusions One-year SAH survivors have two times higher risk of death in comparison with the matched general population, and this higher risk is attributed to cerebrovascular diseases, such as brain infarcts, and intracerebral haemorrhages. Restrain from smoking, and effective control of high blood pressure and serum cholesterol may improve the prognosis of SAH survivors remarkably.