Significant improvements in brain haemorrhage treatment
Significant improvements in brain haemorrhage treatment
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Thursday, 04, Jun 2009 09:11
There has been a 17 per cent decrease in the likelihood of death from aneurysmal subarachnoid haemorrhage (the bursting of a blood vessel on the surface the brain) over the last 30 years, new research shows.
A report published in the Lancet Neurology has credited the decline with improvement in diagnosis and treatment over the past three decades.
It is believed aneurysmal subarachnoid haemorrhage (SAH) affects eight in 100,000 people every year in rich nations.
It also causes a large number of incident stroke cases and is associated with a poor outcome — about 30 per cent of patients die within 24 hours and of those who survive more than a quarter are left disabled.
The report credits recent advances in diagnosis and treatments including CT and MRI techniques for detection of aneurysms, dedicated stroke units, and endovascular coiling of burst aneurysms having greatly improved the prognosis of patients who reach hospital in good condition and are suitable for these treatments.
As part of the new study, researchers analysed 33 studies involving 8,739 patients from 19 countries in five continents between 1972 and 2002.
Their findings showed that despite an increase in the average age of patients with SAH from 52 to 62 years, over three decades the likelihood of dying from a SAH has declined from 51 per cent to 35 per cent — a decrease of 0.6 per cent per year.
Case fatality rates (proportion of people who die) in Japan were found to be significantly lower (11.8 per cent lower) than in Europe, USA, Australia, and New Zealand. The authors suggest the differences may be the result of variation in the speed of patients' admission to hospital for the early occlusion of the aneurysm.
The authors conclude: "In future, case-fatality after SAH might decrease even more, owing to new diagnostic and therapeutic methods…[however the focus should also be on case-morbidity]…because of the high costs from the loss of productive life-years and the long-term care of patients with SAH who become and remain disabled from a young age."