Aging Changes of Aneurysmal Subarachnoid Hemorrhage: A 35-year,Hospital-Based Study

BackgroundThe etiology and background factors which cause decreases in the size of ruptured intracranial aneurysms remain unclear.ObjectiveTo clarify the age- and sex-related differences in aneurysmal subarachnoid hemorrhage (SAH) based on a 35-year-old hospital database and demographic data.MethodsA database of patients admitted to our hospital with aneurysmal SAH from 1983 to 2017 was split into 5-year intervals and analyzed. Demographic data of the general population were also analyzed for reference.ResultsAltogether, 1,523 aneurysmal SAH events were enrolled in the analysis. Age (p<0.001), proportion of elderly patients ≥ 65 years old (p<0.001), female sex (p=0.005), very small aneurysms less than 5 mm (p<0.001), and the yearly-averaged number of fatal events showed increasing trends. The proportion of aneurysm size of 10 mm or more (p = 0.011) and the yearly-averaged population of Shimane prefecture (p < 0.001) showed declining trends. In the subgroup analyses, the proportion of very small aneurysms was found to increase significantly in the non-elderly male and elderly female subgroups. The proportion of large aneurysms (10 mm or more) decreased in the non-elderly subgroup (p<0.05). As for the elderly subgroups, the yearly-averaged number of events did not show a significant tendency, although the yearly-averaged population of Shimane prefecture showed an increasing trend.ConclusionWe found an increasing trend in the prevalence of very small aneurysms in elderly females. Recent aging may contribute to this trend. The number of aneurysmal SAH events was confirmed to not increase, despite the increased aging population of Shimane prefecture.