The burden, trends, and demographics of mortality from subarachnoid hemorrhage

OBJECTIVE: The objective of this study was to describe the recent epidemiology of mortality from subarachnoid hemorrhage in the United States. BACKGROUND: Subarachnoid hemorrhage is distinct from other forms of stroke in its risk factors, demographics, and treatment. However, it is often clustered with other stroke subtypes, obscuring its unique epidemiology. METHODS: We analyzed subarachnoid hemorrhage mortality data from the National Center for Health Statistics of the United States for the years 1979 to 1994 and compared it with other stroke subtypes. RESULTS: Age-adjusted mortality rates of subarachnoid hemorrhage were 62% greater in females than in males and 57% greater in blacks than in whites. The median age of death from subarachnoid hemorrhage was 59 years compared with 73 years for intracerebral hemorrhage and 81 years for ischemic stroke. Mortality rates of subarachnoid hemorrhage have decreased by approximately 1% per year since 1979, and the mean age of death has steadily increased from 57 years in 1979 to 60 years in 1994. Subarachnoid hemorrhage accounted for 4.4% of stroke mortality but 27.3% of all stroke-related years of potential life lost before age 65, a measure of premature mortality. The proportion of years of potential life lost due to subarachnoid hemorrhage was comparable with ischemic stroke (38.5%) and intracranial hemorrhage (34.2%). CONCLUSIONS: Subarachnoid hemorrhage is an uncommon cause of stroke mortality but occurs at a young age, producing a relatively large burden of premature mortality, comparable with ischemic stroke.