University of Oulu

Virta, J.J., Skrifvars, M., Reinikainen, M. et al. Trends in Mortality after Intensive Care of Patients with Aneurysmal Subarachnoid Hemorrhage in Finland in 2003–2019: A Finnish Intensive Care Consortium study. Neurocrit Care 37, 447–454 (2022).

Trends in mortality after intensive care of patients with aneurysmal subarachnoid hemorrhage in Finland in 2003–2019 : a Finnish Intensive Care Consortium study

Saved in:
Author: Virta, Jyri J.1,2; Skrifvars, Markus3; Reinikainen, Matti4;
Organizations: 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
2Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
3Department of Emergency Care and Services, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
4Department of Anesthesiology and Intensive Care, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
5Department of Perioperative Services, Intensive Care and Pain Management, Turku University Hospital, University of Turku, Turku, Finland
6Department of Intensive Care and Emergency Medicine Services, Department of Emergency, Anesthesia and Pain Medicine, Tampere University Hospital, University of Tampere, Tampere, Finland
7Research Group of Surgery, Anesthesiology and Intensive Care, Division of Intensive Care, Oulu University Hospital, University of Oulu, Medical Research Center, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: Springer Nature, 2022
Publish Date: 2023-05-29


Background: Previous studies suggest that case mortality of aneurysmal subarachnoid hemorrhage (aSAH) has decreased during the last decades, but most studies have been unable to assess case severities among individual patients. We aimed to assess changes in severity-adjusted aSAH mortality in patients admitted to intensive care units (ICUs).

Methods: We conducted a retrospective, register-based study by using the prospectively collected Finnish Intensive Care Consortium database. Four out of five ICUs providing neurosurgical and neurointensive care in Finland participated in the Finnish Intensive Care Consortium. We extracted data on adult patients admitted to Finnish ICUs with aSAH between 2003 and 2019. The primary outcome was 12-month mortality during three periods: 2003–2008, 2009–2014, and 2015–2019. Using a multivariable logistic regression model—with variables including age, sex, World Federation of Neurological Surgeons grade, preadmission dependency, significant comorbidities, and modified Simplified Acute Physiology Score II—we analyzed whether admission period was independently associated with mortality.

Results: A total of 1,847 patients were included in the study. For the periods 2003–2008 and 2015–2019, the mean number of patients with aSAH admitted per year increased from 81 to 123. At the same time, the patients’ median age increased from 55 to 58 years (p = 0.001), and the proportion of patients with World Federation of Neurological Surgeons grades I–III increased from 42 to 58% (p  < 0.001). The unadjusted 12-month mortality declined from 30% in 2003–2008 to 23% in 2015–2019 (p = 0.001), but there was no statistically significant change in severity-adjusted mortality.

Conclusions: Between 2003 and 2019, patients with aSAH admitted to ICUs became older and the proportion of less severe cases increased. Unadjusted mortality decreased but age and case severity adjusted–mortality remained unchanged.

see all

Series: Neurocritical care
ISSN: 1541-6933
ISSN-E: 1556-0961
ISSN-L: 1541-6933
Volume: 37
Issue: 2
Pages: 447 - 454
DOI: 10.1007/s12028-021-01420-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: © 2021 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit