1887
Volume 2020, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Spontaneous subarachnoid hemorrhage (SAH) is one of the significant etiologies for stroke. SAH causes higher morbidity and mortality with loss of productivity, resulting in increased disease burden. Only few studies in Qatar have reported on SAH, and the epidemiological features of SAH and aneurysmal SAH (aSAH) have not been comprehensively studied before in Qatar. Our study aimed to describe the epidemiological profile of patients with SAH and aSAH in the State of Qatar.

Methods: We reviewed the medical records of all patients with SAH and/or ruptured aneurysm who were consecutively admitted to Hamad General Hospital (600-bed tertiary care facility) from January 1, 2007 to December 31, 2016. We performed a quantitative analysis of demographics, clinical characteristics, diagnostic findings, interventions, and overall mortality. We used SPSS version 18 for data entry. We used chi-square and student t tests to compare the groups. We considered  < 0.05 as statistically significant.

Results: The study included 323 patients with aneurysmal and non-aneurysmal SAH. The mean age at presentation was 47.4 ± 12.2 years. Men comprised 68.7% of the cases. Further, 86.6% of the patients presented with acute-onset headache. Additionally, 217 patients had 1 aneurysm, and 32 patients had multiple aneurysms. Anterior communicating artery aneurysm has been found to be the most common aneurysm. Non-aneurysmal SAH occurred in 74 patients (22.9%), with male predominance. Moreover, 23.7% and 52.6% of the patients underwent microsurgical clipping and coiling of the aneurysm, respectively. The overall mortality in World Federation of Neurosurgeon Score (WFNS) grades 1 and 2 SAH was lesser than that in higher grades (28.6% vs 71.4%). Of 323 patients, 69 died within 1 month post-ictus, accounting for an overall mortality rate of 21.2% in our study.

Conclusions: The annual incidence of aneurysmal SAH in Qatar has been increasing. Men had a higher incidence of aSAH. Internal carotid aneurysms have been found to be more common in Qatari women, which may have a genetic basis. Lower WFNS grades of aSAH have been associated with better prognosis. The overall mortality associated with aSAH in Qatar has declined over the last 3 years.

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2020-07-16
2024-11-14
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References

  1. Donkor ES. Stroke in the century: a snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat. 2018; 2018::110.
    [Google Scholar]
  2. Dhandapani S, Singh A, Singla N, Praneeth K, Aggarwal A, Sodhi HB, et al.  Has outcome of subarachnoid hemorrhage changed with improvements in neurosurgical services? Stroke. 2018; 49::28902895.
    [Google Scholar]
  3. Johnston SC, Selvin S, Gress DR. The burden, trends, and demographics of mortality from subarachnoid hemorrhage. Neurology. 1998; 50::14131418.
    [Google Scholar]
  4. Ingall T, Asplund K, Mahonen M, Bonita R. A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke. 2000; 31::10541061.
    [Google Scholar]
  5. Nogueira GJ. Spontaneous subarachnoid haemorrhage and ruptured aneurysms in the middle east. A myth revisited. ActaNeurochir (Wien). 1992; 114::2025.
    [Google Scholar]
  6. D'Souza S. Aneurysmal subarachnoid hemorrhage. J Neurosurg Anesthesiol. 2015; 27::222240.
    [Google Scholar]
  7. http//www.psa.gov.qa/en/pages/defult.aspx. Downloaded on 13/01/2020.
  8. Osman N, Ramesh N. Perimesencephalic non-aneurysmal subarachnoid haemorrhage. BMJ Case Rep. 2018; 2018::12.
    [Google Scholar]
  9. Koffijberg H, Buskens E, Granath F, Adami J, Ekbom A, Rinkel GJ, et al.  Subarachnoid haemorrhage in Sweden 1987–2002: regional incidence and case fatality rates. J Neurol Neurosurg Psychiatry. 2008; 79::294299.
    [Google Scholar]
  10. van Munster CE. von und zu Fraunberg M. Rinkel GJ, Rinne J, Koivisto T, Ronkainen A. Differences in aneurysm and patient characteristics between cohorts of Finnish and Dutch patients with subarachnoid hemorrhage: time trends between 1986 and 2005. Stroke. 2008; 39::31663171.
    [Google Scholar]
  11. Wáng YX, He J, Zhang L, Li Y, Zhao L, Liu H, et al.  A higher aneurysmal subarachnoid hemorrhage incidence in women prior to menopause: a retrospective analysis of 4,895 cases from eight hospitals in China. Quant Imaging Med Surg. 2016; 6::151156.
    [Google Scholar]
  12. de Falco FA. Sentinel headache. Neurol Sci. 2004; 25::S215S217.
    [Google Scholar]
  13. Edlow JA. Diagnosing headache in the emergency department: what is more important? Being right, or not being wrong? Eur J Neurol. 2008; 15::12571258.
    [Google Scholar]
  14. Fontanarosa PB. Recognition of subarachnoid hemorrhage. Ann Emerg Med. 1989; 18::11991205.
    [Google Scholar]
  15. Ohman J. Hypertens as a risk factor for epilepsy after aneurysmal subarachnoid hemorrhage and surgery. Neurosurgery. 1990; 27::578581.
    [Google Scholar]
  16. Bederson JB, Connolly ES Jr, Batjer HH, Dacey RG, Dion JE, Diringer MN, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association published correction appears in Stroke. 2009; 40:e518. Stroke 2009; 40:994–1025.
  17. Cortnum S, Sørensen P, Jørgensen J. Determining the sensitivity of computed tomography scanning in early detection of subarachnoid hemorrhage. Neurosurgery. 2010; 66::900902.
    [Google Scholar]
  18. Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, et al.  International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005; 366::809817.
    [Google Scholar]
  19. Spetzler RF, McDougall CG, Zabramski JM, Albuquerque FC, Hills NK, Russin JJ, et al.  The barrow ruptured aneurysm trial: 6-year results. J Neurosurg. 2015; 123::609617.
    [Google Scholar]
  20. Kerr R, Molyneux A, The barrow ruptured aneurysm trial and international subarachnoid aneurysm trial. J Neurosurg. 2013; 118::478480.
    [Google Scholar]
  21. Konczalla J, Schmitz J, Kashefiolasl S, Senft C, Seifert V, Platz J. Non-aneurysmal subarachnoid hemorrhage in 173 patients: a prospective study of long-term outcome. Eur J Neurol. 2015; 0::18.
    [Google Scholar]
  22. Etminan N, Chang H, Hackenberg K, et al.  Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: A systematic review and meta-analysis. JAMA Neurol. 2019; 76::588597.
    [Google Scholar]
  23. Rouanet C, Silva GS. Aneurysmal subarachnoid hemorrhage: current concepts and updates. Arquivos de Neuro-Psiquiatria. 2019; 77::806814.
    [Google Scholar]
  24. Okazaki T, Kuroda Y. Aneurysmal subarachnoid hemorrhage: intensive care for improving neurological outcome. J Intensive Care. 2018; 6::28.
    [Google Scholar]
  25. Zheng K, Zhong M, Zhao B, Chen S-Y, Tan X-X, Li Z-Q, et al.  Poor-grade aneurysmal subarachnoid hemorrhage: risk factors affecting clinical outcomes in intracranial aneurysm patients in a multi-center study. Front Neurol. 2019; 10::123.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): cerebral aneurysmepidemiologyQatar and Subarachnoid hemorrhage
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