Subarachnoid haemorrhage in Germany between 2010-2013: estimated incidence rates based on a nationwide hospital discharge registry.

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Subarachnoid haemorrhage in Germany between 2010-2013: estimated incidence rates based on a nationwide hospital discharge registry.

World Neurosurg. 2017 May 19;:

Authors: van Lieshout JH, Fischer I, Kamp MA, Donders ART, Cornelius JF, Steiger HJ, Boogaarts HD, Petridis AK

Abstract
BACKGROUND: Nordic countries are the primary source for nationwide data on the incidence of subarachnoid haemorrhage (SAH). Reliable estimates of national incidence rates of SAH in other countries are lacking, yet studies from Nordic countries with exceptional incidence rate are sometimes disregarded because of concerns regarding external validity. Autopsies are rarely performed for sudden deaths, therefore estimates of the SAH incidence commonly reflect the hospital discharge rates. Our aim was to estimate the nationwide incidence of non-traumatic SAH in Germany using a national hospital discharge register.
METHODS: The German federal statistical office provided the number of patients discharged from all German hospitals between 2010 and 2013 with the primary diagnosis of non-traumatic SAH (ICD Code I60.0-I60.9) and corresponding age distribution. Age standardised attack rates of non-traumatic SAH were calculated using the 2011 German demographic distribution.
RESULTS: Between 2010 and 2013, the overall age standardised incidence rate of non-traumatic SAH was 11.3 per 100,000 person-years and reached a maximum of 22.1 per 100,000 person-years in the oldest age group. The absolute number of SAH was highest in the group aged 50-55 years. The distribution of intracranial aneurysms displayed a propensity towards the posterior circulation with advancing age (p<0.001), although in absolute numbers SAH originated mostly from the anterior circulation.
CONCLUSIONS: Our estimate of the German nationwide attack rate suggests that the incidence of non-traumatic SAH is more homogeneous than previously assumed. Rejecting the external validity of studies from countries believed to display an exceptional incidence rates may therefore not be justified.

PMID: 28532918 [PubMed - as supplied by publisher]

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