Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage

Joseph P. Broderick, Thomas G Brott, John E. Duldner, Thomas Tomsick, Alan Leach

Research output: Contribution to journalArticle

518 Citations (Scopus)

Abstract

Background and Purpose: The goal of this study was to determine the causes of mortality and morbidity after subarachnoid hemorrhage. Methods: We identified all first-ever spontaneous subarachnoid hemorrhages that occurred in the nearly 1.3 million population of greater Cincinnati during 1988. Results: Thirty-day mortality for subarachnoid hemorrhage was 45% (36 of 80 cases). Of the 36 deaths, 22 (61%) died within 2 days of onset; 21 of these deaths were due to the initial hemorrhage, and one death was due to rebleeding documented by computed tomography. Nine of the remaining 14 deaths after day 2 were caused by the initial hemorrhage (2 cases) or rebleeding (7 cases). Volume of subarachnoid hemorrhage was a powerful predictor of 30-day mortality (P=.0001). Only 3 of the 29 patients with a volume of subarachnoid hemorrhage of 15 cm3 or less died before 30 days. Two of these 3 patients died from documented rebleeding; the third had 87 cm3 of additional intraventricular hemorrhage. Delayed arterial vasospasm contributed to only 2 of all 36 deaths. Conclusions: Most deaths after subarachnoid hemorrhage occur very rapidly and are due to the initial hemorrhage. Rebleeding is the most important preventable cause of death in hospitalized patients. In a large representative metropolitan population, delayed arterial vasospasm plays a very minor role in mortality caused by subarachnoid hemorrhage.

Original languageEnglish (US)
Pages (from-to)1342-1347
Number of pages6
JournalStroke
Volume25
Issue number7
StatePublished - Jul 1994
Externally publishedYes

Fingerprint

Subarachnoid Hemorrhage
Cause of Death
Hemorrhage
Mortality
Population
Tomography
Morbidity

Keywords

  • mortality
  • subarachnoid hemorrhage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Broderick, J. P., Brott, T. G., Duldner, J. E., Tomsick, T., & Leach, A. (1994). Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. Stroke, 25(7), 1342-1347.

Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. / Broderick, Joseph P.; Brott, Thomas G; Duldner, John E.; Tomsick, Thomas; Leach, Alan.

In: Stroke, Vol. 25, No. 7, 07.1994, p. 1342-1347.

Research output: Contribution to journalArticle

Broderick, JP, Brott, TG, Duldner, JE, Tomsick, T & Leach, A 1994, 'Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage', Stroke, vol. 25, no. 7, pp. 1342-1347.
Broderick JP, Brott TG, Duldner JE, Tomsick T, Leach A. Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. Stroke. 1994 Jul;25(7):1342-1347.
Broderick, Joseph P. ; Brott, Thomas G ; Duldner, John E. ; Tomsick, Thomas ; Leach, Alan. / Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. In: Stroke. 1994 ; Vol. 25, No. 7. pp. 1342-1347.
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