Demographic Disparities in the Incidence and Case Fatality of Subarachnoid Haemorrhage: An 18-Year Nationwide Study from New Zealand

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aut.relation.issue101199
aut.relation.journalThe Lancet Regional Health - Western Pacific
aut.relation.volume52
dc.contributor.authorRautalin, I
dc.contributor.authorKrishnamurthi, Rita
dc.contributor.authorAnderson, CS
dc.contributor.authorBarber, PA
dc.contributor.authorBarker-Collo, S
dc.contributor.authorBennett, D
dc.contributor.authorBoet, R
dc.contributor.authorCorreia, JA
dc.contributor.authorDouwes, J
dc.contributor.authorLaw, A
dc.contributor.authorNair, B
dc.contributor.authorThrift, AG
dc.contributor.authorTe Ao, B
dc.contributor.authorTunnage, B
dc.contributor.authorRanta, A
dc.contributor.authorFeigin, VL
dc.date.accessioned2024-09-24T03:37:46Z
dc.date.available2024-09-24T03:37:46Z
dc.date.issued2024
dc.description.abstractBackground Although the incidence and case-fatality of subarachnoid haemorrhage (SAH) vary within countries, few countries have reported nationwide rates, especially for multi-ethnic populations. We assessed the nationwide incidence and case-fatality of SAH in New Zealand (NZ) and explored variations by sex, district, ethnicity and time. Methods We used administrative health data from the national hospital discharge and cause-of-death collections to identify hospitalised and fatal non-hospitalised aneurysmal SAHs in NZ between 2001 and 2018. For validation, we compared these administrative data to those of two prospective Auckland Regional Community Stroke Studies. We subsequently estimated the incidence and case-fatality of SAH and calculated adjusted rate ratios (RR) with 95% confidence intervals to assess differences between sub-populations. Findings Over 78,187,500 cumulative person-years, we identified 5371 SAHs (95% sensitivity and 85% positive predictive values) resulting in an annual age-standardised nationwide incidence of 8.2/100,000. In total, 2452 (46%) patients died within 30 days after SAH. Compared to European/others, Māori had greater incidence (RR = 2.23 (2.08–2.39)) and case-fatality (RR = 1.14 (1.06–1.22)), whereas SAH incidence was also greater in Pacific peoples (RR = 1.40 (1.24–1.59)) but lesser in Asians (RR = 0.79 (0.71–0.89)). By domicile, age-standardised SAH incidence varied between 6.3–11.5/100,000 person-years and case fatality between 40 and 57%. Between 2001 and 2018, the SAH incidence of NZ decreased by 34% and the case fatality by 12%. Interpretation Since the incidence and case-fatality of SAH varies considerably between regions and ethnic groups, caution is advised when generalising findings from focused geographical locations for public health planning, especially in multi-ethnic populations.
dc.identifier.citationThe Lancet Regional Health - Western Pacific, ISSN: 2666-6065 (Print); 2666-6065 (Online), Elsevier, 52(101199). doi: 10.1016/j.lanwpc.2024.101199
dc.identifier.doi10.1016/j.lanwpc.2024.101199
dc.identifier.issn2666-6065
dc.identifier.issn2666-6065
dc.identifier.urihttp://hdl.handle.net/10292/18045
dc.publisherElsevier
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S2666606524001937
dc.rights© 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject3202 Clinical sciences
dc.subject4203 Health services and systems
dc.subject4206 Public health
dc.titleDemographic Disparities in the Incidence and Case Fatality of Subarachnoid Haemorrhage: An 18-Year Nationwide Study from New Zealand
dc.typeJournal Article
pubs.elements-id569177
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