Ronkainen A, Niskanen M, Rinne J, Koivisto T, Hernesniemi J, Vapalahti M
Department of Neurosurgery, University Hospital of Kuopio, Kuopio, Finland.
Stroke. 2001 Dec 1;32(12):2850-3. doi: 10.1161/hs1201.099711.
The purpose of this study was to examine the long-term mortality rate of patients with aneurysmal subarachnoid hemorrhage (SAH) compared with that of the general population.
Aneurysmal SAH patients who were treated for ruptured aneurysm from 1977 through 1998 in a tertiary referral center (n=1537) were followed up for a median of 7.5 years. Dates and causes of death were determined. Standardized mortality ratios (observed/expected deaths) according to age, sex, and Glasgow Outcome Scale at 12 months after surgery were calculated.
The mortality rate among patients with good recovery at 12 months was twice that of the general population. The excess mortality appeared to be most evident in younger age groups. Cerebrovascular and cardiovascular diseases were the principal causes of premature death. The result was similar among patients without preexisting cardiovascular diseases at the time of SAH.
Aneurysmal SAH patients have an excess mortality rate even after successful treatment of ruptured aneurysms. Therefore, aneurysmal SAH should be viewed more as one aspect of a chronic general vascular disease, and more attention should be given to treatment of risk factors and long-term follow-up of these patients.
本研究旨在比较动脉瘤性蛛网膜下腔出血（SAH）患者与普通人群的长期死亡率。
对1977年至1998年在一家三级转诊中心接受破裂动脉瘤治疗的动脉瘤性SAH患者（n = 1537）进行了中位时间为7.5年的随访。确定了死亡日期和原因。计算了根据年龄、性别和术后12个月格拉斯哥预后量表得出的标准化死亡率（观察到的死亡数/预期死亡数）。
术后12个月恢复良好的患者死亡率是普通人群的两倍。额外死亡率在较年轻年龄组中似乎最为明显。脑血管疾病和心血管疾病是过早死亡的主要原因。在SAH发生时无心血管疾病的患者中结果相似。
即使破裂动脉瘤成功治疗后，动脉瘤性SAH患者仍有较高死亡率。因此，动脉瘤性SAH应更多地被视为慢性全身性血管疾病的一个方面，并且应更加关注这些患者危险因素的治疗和长期随访。
