Inagawa T
Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Surg Neurol. 1997 Jan;47(1):47-52; discussion 52-3. doi: 10.1016/s0090-3019(96)00370-9.
From 1987-92 in Izumo City, Japan, we diagnosed 123 patients as having subarachnoid hemorrhage (SAH) by computed tomography, autopsy, or surgery (proven SAH); the crude incidence rate was 25/100,000/year for all ages. However, to estimate the actual incidence and mortality rates, we should take into account the decedents who died without confirmation by these methods but were presumed to have died of SAH.
From 1987-92, we reviewed all of 3562 death certificates for the city of Izumo (population 82,679), and calculated the incidence and mortality rates of SAH by combining proven and possible SAH.
We diagnosed 36 patients as having possible SAH on death certificates. When adding these 36 patients to the 123 with proven SAH, the crude and the age-adjusted and sex-adjusted incidence rates for all ages became 32/ 100,000/year and 29/100,000/year, respectively. Of these, 40% (64) died by day 3 (day 0 defined as the day of hemorrhage), 43% (69) within 1 week, and 53% (84) within 1-6 months, respectively.
When including the patients who may have died of SAH, the actual incidence rate of SAH is much higher than that which has been reported to date, and the actual mortality rate is still very high.
1987年至1992年期间，在日本出云市，我们通过计算机断层扫描、尸检或手术诊断出123例患者患有蛛网膜下腔出血（SAH）（确诊SAH）；各年龄段的粗发病率为每年25/100,000。然而，为了估计实际发病率和死亡率，我们应考虑那些未经这些方法确诊但被推定死于SAH的死者。
1987年至1992年期间，我们查阅了出云市（人口82,679）的所有3562份死亡证明，并通过合并确诊和可能的SAH来计算SAH的发病率和死亡率。
我们在死亡证明上诊断出36例可能患有SAH的患者。将这36例患者与123例确诊SAH的患者相加后，各年龄段的粗发病率以及年龄和性别调整后的发病率分别变为每年32/100,000和每年29/100,000。其中，分别有40%（64例）在第3天死亡（第0天定义为出血当天），43%（69例）在1周内死亡，53%（84例）在1至6个月内死亡。
当纳入可能死于SAH的患者时，SAH的实际发病率远高于迄今报道的发病率，且实际死亡率仍然很高。
