Demographics and Short-Term Outcomes of Spontaneous Subarachnoid Hemorrhage in Young Adults

World Neurosurg. 2017 Jun:102:414-419. doi: 10.1016/j.wneu.2017.03.069. Epub 2017 Mar 24.

Abstract

Objective: Spontaneous subarachnoid hemorrhage (SAH) is a catastrophic disease with a high mortality. Although it is associated with poor prognosis in older patients, the socioeconomic consequences in younger patients with stroke may be more severe. We aimed to focus on the demographics and short-term outcomes of SAH in a population younger than 50 years.

Methods: We retrospectively enrolled 1689 patients with a primary diagnosis of SAH from 1993 to 2010. We identified intergroup differences in clinical variables between the patients aged 18-49 years (n = 531) and those aged ≥50 years (n = 1158).

Results: The patients with SAH included 688 men and 1001 women (an overall male/female ratio of 1:1.45), of whom 31.4% were aged 18-49 years. Men comprised 53.5% of the younger patients and 34.9% of the older patients (P < 0.01). The post-SAH sequela of hemiplegia was more common in the younger patients (P < 0.01), whereas the incidences of in-hospital mortality in the younger and older groups were 25.4% and 32.4%, respectively (P < 0.01).

Conclusions: Adults younger than 50 years account for a significant portion of the population with SAH. There is a male predominance in this age group, probably related to early and substantial risk exposure. Although younger age imparts a higher probability of survival, it is also accompanied by a greater incidence of resultant sequelae. A better understanding of the age-related variability of SAH will assist in guidance for public health and adjustment of clinical management.

Keywords: Mortality; Outcome; Subarachnoid hemorrhage; Young.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Demography*
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Hypertension / epidemiology
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Diseases / epidemiology
  • Liver Diseases / epidemiology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Subarachnoid Hemorrhage / epidemiology*
  • Subarachnoid Hemorrhage / mortality
  • Subarachnoid Hemorrhage / therapy*
  • Taiwan / epidemiology
  • Young Adult