Overall mortality of those reaching hospital has declined from 30% in the 1960s , to 20% in the 1980s [9,24], to its present level of 5-10% . With it there has been a corresponding improvement in reported favorable outcome of 50% in the 1970s, to 70% in the 1980s [9,25], to 80% in the most recent series . This trend has been seen in all age groups except the elderly. A population-based study showed no change in survival rates but an increase in the number of individuals making an independent outcome to 82% in 1980-7 compared to 64% in 1976-8. This improvement has been attributed to the early referral of patients to specialist units, advances in medical treatment and aggressive management to minimize the risks of re-bleeding and spasm, and particularly the practice of early surgery in good-grade patients.
Pre-hospital mortality is 3-26%, with an overall mortality of 45-60% in the first 30 days after SAH. The fatality rate decreases sharply after the hemorrhage: of all the deaths occurring during the first 3 months, the fatality rate is 61% in the first 2 days, 65% in the first week, 12% during the second week and 4% during the third week. Thereafter, the weekly fatalities up to 3 months average out at 1.6%. Most deaths in the first 2 days (58%) are due to the initial ictus, whilst, after 3 days, 22-38% are due to a repeat bleed and a further significant proportion (23%) due to vasospasm . Survival at 1 year is 52-62%.
Was this article helpful?
The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.