Incidence and Case Fatality of Subarachnoid Haemorrhage in Northern Greece: The Evros Registry of Subarachnoid Haemorrhage

Abstract

Epidemiological data on subarachnoid haemorrhage incidence and case-fatality rates are scarce in the south-eastern Mediterranean region. We conducted a population-based study in Evros Province, located in north-eastern Greece, to determine subarachnoid haemorrhage incidence over a 5-year period (2001-2005). Evros Province has a well-defined, largely homogeneous population with healthcare organised around a single tertiary-care University Hospital. We organised a prospective computerised registry of permanent Evros residents admitted or transferred to our hospital with a diagnosis of subarachnoid haemorrhage. Standard World Health Organization definitions and overlapping case-finding methods were used to identify all cases of first ever in a lifetime subarachnoid haemorrhage in all age groups, occurring during the study period. The diagnosis was confirmed by computed tomography scan in all hospitalised cases. Sudden deaths attributable to subarachnoid haemorrhage were systematically recorded province-wide by our forensic department and are included in the study. During the 5-year period, 51 cases of subarachnoid haemorrhage were recorded (28 men, 23 women; mean age 59+/-17 years). The crude annual incidence rates were 8.3/100,000 persons (95% confidence interval: 5.5-12.0) for men, 7.5/100,000 (4.8-11.3) for women and 7.9/100,000 (5.9-10.4) for all subjects. The standardised incidence rates for groups aged 45-84 years in the European population were 9.3/100,000 (5.8-12.8) for men, 6.5/100,000 (3.7-9.4) for women and 7.9/100,000 (5.7-10.2). The 28-day case-fatality rates for men, women and all subjects were 36% (21-54%), 35% (19-55%) and 35% (24-49%), respectively. The incidence and case-fatality rate of subarachnoid haemorrhage haemorrhage in Greece appear to be similar to other developed countries. No gender differences in subarachnoid haemorrhage incidence and case-fatality rate were documented.