- Title
- Case-Fatality and Functional Outcome after Subarachnoid Hemorrhage (SAH) in INternational STRoke oUtComes sTudy (INSTRUCT)
- Creator
- Rehman, Sabah; Phan, Hoang T.; Krishnamurthi, Rita V.; Barker-Collo, Suzanne; Feigin, Valery; Chausson, Nicolas; Olindo, Stephane; Cabral, Noberto L.; Carolei, Antonio; Marini, Carmine; Degan, Diana; Sacco, Simona; Reeves, Mathew J.; Correia, Manuel; Appelors, P; Korv, J; Vibo, R; Minelli, C; Sposato, L; Pandian, JD; Kaur, P; Azarpazhooh, MR; Morovatdar, N; Thrift, Amanda G.; Gall, S; Cadilhac, Dominique A.; Sturm, Jonathan; Breslin, Monique; Callisaya, Michele L.; Vemmos, Konstantinos; Parmar, Priya
- Relation
- Journal of Stroke and Cerebrovascular Diseases Vol. 31, Issue 1, no. 106201
- Publisher Link
- http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.106201
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: There are few large population-based studies of outcomes after subarachnoid hemorrhage (SAH) than other stroke types. Methods: We pooled data from 13 population-based stroke incidence studies (10 studies from the INternational STRroke oUtComes sTudy (INSTRUCT) and 3 new studies; N=657). Primary outcomes were case-fatality and functional outcome (modified Rankin scale score 3-5 [poor] vs. 0-2 [good]). Harmonized patient-level factors included age, sex, health behaviours (e.g. current smoking at baseline), comorbidities (e.g.history of hypertension), baseline stroke severity (e.g. NIHSS >7) and year of stroke. We estimated predictors of case-fatality and functional outcome using Poisson regression and generalized estimating equations using log-binomial models respectively at multiple timepoints. Results: Case-fatality rate was 33% at 1 month, 43% at 1 year, and 47% at 5 years. Poor functional outcome was present in 27% of survivors at 1 month and 15% at 1 year. In multivariable analysis, predictors of death at 1-month were age (per decade increase MRR 1.14 [1.07-1.22]) and SAH severity (MRR 1.87 [1.50-2.33]); at 1 year were age (MRR 1.53 [1.34-1.56]), current smoking (MRR 1.82 [1.20-2.72]) and SAH severity (MRR 3.00 [2.06-4.33]) and; at 5 years were age (MRR 1.63 [1.45-1.84]), current smoking (MRR 2.29 [1.54-3.46]) and severity of SAH (MRR 2.10 [1.44-3.05]). Predictors of poor functional outcome at 1 month were age (per decade increase RR 1.32 [1.11-1.56]) and SAH severity (RR 1.85 [1.06-3.23]), and SAH severity (RR 7.09 [3.17-15.85]) at 1 year. Conclusion: Although age is a non-modifiable risk factor for poor outcomes after SAH, however, severity of SAH and smoking are potential targets to improve the outcomes.
- Subject
- subarachnoid hemorrhage; case-fatality; functional outcome; short-term outcome; long-term outcome; SDG 3; SDG 10; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1459714
- Identifier
- uon:45752
- Identifier
- ISSN:1052-3057
- Language
- eng
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