Incidence, treatment, and case-fatality of non-traumatic subarachnoid haemorrhage in the Netherlands

Clin Neurol Neurosurg. 2011 Jul;113(6):483-7. doi: 10.1016/j.clineuro.2011.02.015. Epub 2011 Mar 21.


Background: Non-traumatic subarachnoid haemorrhage (SAH) is a devastating disorder and in the majority of cases it is caused by rupture of an intracranial aneurysm. No actual data are available on the incidence of non-traumatic SAH and aneursymal SAH (aSAH) in the Netherlands and little is known about treatment patterns of aSAH. Our purpose was therefore to assess the incidence, treatment patterns, and case-fatality of non-traumatic (a)SAH within the Dutch general population.

Methods: Two population based data sources were used for this retrospective cohort study. One was the nationwide hospital discharge registry (National Medical Registration, LMR). Cases were patients hospitalized for SAH (ICD-9-code 430) in 2001-2005. The second source was the Integrated Primary Care Information (IPCI) database, a medical record database allowing for case validation. Cases were patients with validated non-traumatic (a)SAH in 1996-2006. Incidence, treatment, and case-fatality were assessed.

Results: The incidence rate (IR) of non-traumatic SAH was 7.12 per 100,000 PY (95%CI: 6.94-7.31) and increased with age. The IR of aSAH was 3.78 (95%CI: 2.98-4.72). Women had a twofold increased risk of non-traumatic SAH; this difference appeared after the fourth decade. Non-traumatic SAH fatality was 30% (95%CI: 29-31%). Of aSAH patients 64% (95%CI: 53-74%) were treated with a clipping procedure, and 26% (95%CI: 17-37%) with coiling.

Conclusion: Non-traumatic SAH is a rare disease with substantial case-fatality; rates in the Netherlands are similar to other countries. Case-fatality is also similar as well as age and sex patterns in incidence.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Databases, Factual
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Primary Health Care / statistics & numerical data
  • Registries
  • Retrospective Studies
  • Sex Factors
  • Subarachnoid Hemorrhage / epidemiology*
  • Subarachnoid Hemorrhage / mortality
  • Subarachnoid Hemorrhage / therapy*
  • Subarachnoid Hemorrhage, Traumatic / epidemiology
  • Subarachnoid Hemorrhage, Traumatic / mortality
  • Subarachnoid Hemorrhage, Traumatic / therapy
  • Surveys and Questionnaires