Increased incidence of aneurysmal subarachnoid hemorrhage on Sundays and Mondays in 1,862 patients from Eastern Finland.

BACKGROUND

Temporal patterns of aneurysmal subarachnoid hemorrhage (aSAH) from saccular intracranial aneurysm (sIA) were studied in a consecutive series of 1,862 patients.

METHODS

Neurosurgery of Kuopio University Hospital (KUH) solely serves a defined catchment population in Eastern Finland. Kuopio's sIA database contains 1,596 sporadic and 266 familial patients admitted to KUH within 72 h from the onset of aSAH between 1980 and 2007. The distributions by the weekday of the onset of aSAH, admission to KUH, and occlusive therapy of the ruptured sIA were analyzed. Logistic regression was used to search for clinical variables (patients, sIA disease, clinical condition) that would independently correlate with each distribution.

RESULTS

The onset of aSAH occurred significantly most often (p < 0.001) on Sundays (n = 330) and Mondays (n = 309) and least frequently on Saturdays (n = 231). None of the clinical variables tested associated significantly and independently with the Sunday and Monday peaks. The admissions to KUH after aSAH were most frequent (p < 0.001) on Mondays (n = 331) and least frequent on Thursdays (n = 221) and Saturdays (n = 221). Overall, 1,655 patients underwent occlusive therapy, most frequently on Mondays (n = 318) and least frequently on Saturdays (n = 189) and Sundays (n = 197).

CONCLUSIONS

Sundays and Mondays were the most frequent and Saturdays the least frequent days of aSAH in a defined Eastern Finnish population. We could not identify any etiology to this temporal pattern. Binge drinking is frequent in Finland, especially among young males, but age and gender did not correlate with the Sunday and Monday peaks.