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Deaths From Brain Hemorrhage Dramatically Down Since 1973

Improvements in detection and treatment credited with 17 percent drop in deaths

MONDAY, June 8 (HealthDay News) -- Improvements in the management of aneurysmal subarachnoid hemorrhage (SAH) since 1973 have driven a 17 percent decrease in the risk of death from the acute event worldwide, according to a study published online June 4 in The Lancet Neurology.

Dennis J. Nieuwkamp, M.D., of Rudolf Magnus Institute of Neuroscience in Utrecht, Netherlands, and colleagues conducted a meta-analysis of the medical literature on SAH to determine if mortality and morbidity had improved with changes in therapy since a prior meta-analysis in 1997. The new meta-analysis included 33 studies covering 8,739 patients between 1995 and 2007. The analysis looked at mortality trends and associations by age, sex, and region of the world using weighted linear regression.

The researchers found that, despite an increase in the average age of SAH patients from 52 to 62 years old, the risk of dying from SAH fell from 51 percent to 35 percent, an average decline of 0.6 percent per year. Sex had no effect on the reduced risk, but adjustment for age revised the decline to 0.4 percent per year. Mortality rates in Japan were lower than in Europe, the United States, Australia, and New Zealand. Computed tomography and MRI detection techniques, dedicated stroke units, and endovascular coiling of burst aneurysms were credited with the improvement in mortality.

"Despite an increase in the mean age of patients with SAH, case-fatality rates have decreased by 17 percent between 1973 and 2002 and show potentially important regional differences. This decrease coincides with the introduction of improved management strategies," the authors conclude.

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