Long-term outcome after aneurysmal subarachnoid hemorrhage-risks of vascular events, death from cancer and all-cause death
| Autor: | Ale Algra, Gabriel J.E. Rinkel, Arno de Wilde, Marieke J.H. Wermer, Dennis J. Nieuwkamp |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage Neurology Epidemiology Population Kaplan-Meier Estimate Risk Assessment Cohort Studies Young Adult Sex Factors Recurrence Risk Factors Internal medicine Cause of Death Neoplasms medicine Humans Cumulative incidence Prospective Studies Vascular Diseases education Cerebrovascular disease Survival analysis Neuroradiology Aged Netherlands Aged 80 and over education.field_of_study business.industry Hazard ratio Age Factors Middle Aged medicine.disease Survival Analysis Treatment Outcome Ischemic Attack Transient Anesthesia Female Neurology (clinical) business Follow-Up Studies |
| Zdroj: | Journal of Neurology, 261(2), 309-315 |
| Popis: | Smoking and hypertension are risk factors for aneurysmal subarachnoid hemorrhage (aSAH), but also for other cardiovascular diseases and cancer. Few prospective data are available on the very long term risks of vascular diseases and vascular, cancer-related and overall death after aSAH. We determined vascular events and survival status in 1,765 patients with aSAH admitted to our center from 1985 to 2010. Cumulative risks were estimated with survival analysis. We compared risks of vascular, cancer-related and all-cause death with the general population with standardized mortality ratios (SMRs). Incidences of vascular events and death were compared with those after TIA/minor stroke. Conditional on surviving 3 months after aSAH, the risk of death was 8.7 % (95 % CI 7.3–10.1) within 5 years, 17.9 % (16.1–19.9) within 10 years, 29.5 % (27.3–31.8) within 15 years, and 43.6 % (41.2–46.1) within 20 years after SAH. The SMR for all-cause death was 1.8 (1.6–2.1), for vascular death 2.0 (95 % CI 1.6–2.5) and for cancer-related death 1.2 (0.9–1.5; sensitivity analysis 1.4; 95 % CI 1.1–1.8). The increased SMR for all-cause death persevered up to 20 years after aSAH. Compared with TIA/minor stroke patients, the age- and sex-adjusted cumulative incidence on vascular events was lower for aSAH patients [hazard ratio (HR) 0.48; 95 % CI 0.40–0.57); the HR for all-cause death was 0.96 (95 % CI 0.84–1.10). After aSAH, risks of vascular events and death, and probably also that of cancer-related death, are higher than in the general population. Although the long-term risk of vascular events was lower in aSAH patients than in TIA/minor stroke patients, the risk of death was similar. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|