Trends in the mortality of non-traumatic subarachnoid hemorrhage in Colombia: a 10-year analysis of a nationwide registry

Alcalá-Cerra, Gabriel; Young, Adam M.H.; Paternina-Caicedo, Ángel; Ribas, Eduardo Santamaria Carvalhal; ,

doi:10.1590/0004-282X20130164

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Sumário

Articles • Arq. Neuro-Psiquiatr. 71 (11) • Nov 2013 • https://doi.org/10.1590/0004-282X20130164 copy

Trends in the mortality of non-traumatic subarachnoid hemorrhage in Colombia: a 10-year analysis of a nationwide registry

Tendências na mortalidade relacionada a hemorragia subaracnóidea na Colômbia: análise de um registro nacional de 10 anos

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To assess trends in mortality from 1999 to 2008 resulting from non-traumatic subarachnoid hemorrhage (SAH) in the Colombian population.

Method

This population-based study analyzed all deaths by assuming a Poisson model.

Results

Subarachnoid hemorrhage-related deaths showed a statistically significant increase of 1.6% per year (p<0.001). The age-standardized analysis demonstrated an increased mortality trend of 3.3% per year (p<0.001) in people older than 70 years, but a decreased mortality trend in people younger than 50. It remained stable in patients 50-69 years old.

Conclusion

The overall SAH-related mortality rate in Colombia has increased because increased mortality among the elderly has been counterbalanced by reduced mortality rates in younger age groups. These disparities may reflect epidemiologic transition, treatment inequities, or a less favorable comorbid profile.

intracranial aneurysm; subarachnoid hemorrhage; morbidity; mortality

Year	Deaths rate	Mortality due to SAH	Mortality rate of SAH
Year	(per 100,000 people)	Mortality due to SAH	(per 100,000 people)
1999	460.72	0.84%	3.86
2000	463.92	0.86%	3.98
2001	468.12	0.82%	3.85
2002	464.22	0.83%	3.87
2003	458.32	0.96%	4.39
2004	445.26	0.93%	4.12
2005	440.46	0.99%	4.36
2006	443.81	0.97%	4.31
2007	440.45	0.98%	4.30
2008	416.78	1.03%	4.30

Age group (y)	Male	Female	p-value
<20	0.32	0.28	0.12
20–24	0.91	0.72	0.047 ^*
25–29	1.28	1.11	0.185
30–34	1.60	1.57	0.898
35–39	2.38	2.69	0.099
40–44	3.62	4.53	<0.001 ^*
45–49	5.76	8.08	<0.001 ^*
50–54	8.02	10.78	<0.001 ^*
55 –59	10.14	13.06	<0.001 ^*
60–64	12.16	17.79	<0.001 ^*
65–69	15.53	25.14	<0.001 ^*
70–74	19.53	32.05	<0.001 ^*
75–79	22.61	36.36	<0.001 ^*
>80	36.24	48.47	<0.001 ^*

Age group	Male		Female
Age group	Coefficient (95% CI)	p-value	Coefficient (95% CI)	p-value
<40	–3.1% (–5% to –1.2%)	0.002	–2.4% (–4.3% to –0.5%)	0.014 ^*
40–49	–3% (–5% to –0.9%)	0.004	–2.6% (–4.3% to –0.9%)	0.003 ^*
50–59	–0.3% (–2.1% to 1.6%)	0.754	–0.5% (–2.1% to 1%)	0.495
60–69	–0.3% (–2.2% to 1.6%)	0.729	–0.1% (–1.5% to 1.4%)	0.920
≥ 70	3.6% (2% to 5.3%)	<0.001	3.2% (2% to 4.4%)	<0.001 ^*
Total	1.1% (0.3% to 2%)	0.008	1.9% (1.2% to 2.6%)	<0.001 ^*

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[1] Faculty of Medicine, Universidad de Cartagena, Cartagena de Indias, Colombia.