Incidence and outcome of subarachnoid haemorrhage in the general and emergency department populations in Queensland from 2010 to 2014

Chu, Kevin H. and Mahmoud, Ibrahim and Hou, Xiang-Yu and Winter, Craig D. and Jeffree, Rosalind L. and Brown, Nathan J. and Brown, Anthony F. T. (2018) Incidence and outcome of subarachnoid haemorrhage in the general and emergency department populations in Queensland from 2010 to 2014. Emergency Medicine Australasia, 30 (4). pp. 503-510. ISSN 1742-6731


Abstract

Objectives
To determine: (i) incidence and outcome of subarachnoid haemorrhage (SAH) in the general population; and (ii) proportions of SAH in both the general ED population and in ED patients presenting with headache.

Methods
A population-based study in Queensland from January 2010 to December 2014 was conducted. Data were sourced from the Australian Bureau of Statistics, Queensland Hospital Admitted Patient Data Collection linked to the Queensland death registry and ED Information System. Admitted patients with SAH were identified from ICD-10-AM codes. Inter-hospital transfers and repeat admissions for previously diagnosed SAH were excluded. Pre-hospital deaths from SAH were included. ED patients with headache were identified from ICD-10-AM codes and finding ‘headache’ in the triage free-text entry. The incidence of SAH, in-hospital mortality, proportions of SAH in the general ED population and ED patients with headache were calculated.

Results
There were 1975 incident cases of SAH in admitted patients and 294 pre-hospital deaths from SAH. The incidence of SAH was 9.9 (95% confidence interval [CI] 9.5–10.4) per 100 000 person-years. The incidence standardised to the ‘World Standard Population’ was 7.0 per 100 000 person-years. The in-hospital mortality was 23.8% (95% CI 22.0–25.8%). SAH was found in 1407 (1.9%, 95% CI 1.8–2.0) of ED patients with headache. Overall, there were 2.4 (95% CI 2.3–2.5) SAH per 10 000 of all ED attendances.

Conclusions
The incidence of SAH was similar to that previously reported for Australia. One in 50 ED patients with headache had SAH. Ten in 50 000 ED attendances had a SAH. These estimates can assist in the risk assessment for SAH.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 17 Jun 2021 01:10
Last Modified: 31 Aug 2021 23:43
Uncontrolled Keywords: Emergency department; epidemiology; headache; incidence; subarachnoid haemorrhage
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111706 Epidemiology
11 Medical and Health Sciences > 1103 Clinical Sciences > 110305 Emergency Medicine
Fields of Research (2020): 42 HEALTH SCIENCES > 4202 Epidemiology > 420299 Epidemiology not elsewhere classified
Socio-Economic Objectives (2008): C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases
Socio-Economic Objectives (2020): 20 HEALTH > 2003 Provision of health and support services > 200311 Urgent and critical care, and emergency medicine
Identification Number or DOI: https://doi.org/10.1111/1742-6723.12936
URI: http://eprints.usq.edu.au/id/eprint/42229

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