Declining trend in the estimated annual rupture rate of unruptured cerebral aneurysms in Japan: a nationwide study

Maeda Yuyo

Ikawa Fusao

Kuwabara Masashi

Hosogai Masahiro

Ishii Daizo

Morimoto Takeshi

Nakayama Takeo

Suzuki Michiyasu

Horie Nobutaka

Neurosurgical Review

The incidence of subarachnoid hemorrhages (SAHs) in Japan has recently decreased. However, trends in the annual rates of unruptured cerebral aneurysms (UCAs) are unclear because calculations based on follow-up periods are limited to patients with ruptured cerebral aneurysms. We aimed to clarify current trends in the estimated annual rupture rates of UCAs in Japan and to identify the most relevant contributing factors. We analyzed data from the Japanese Ministry of Health, Labour and Welfare and records of the Japan Neurosurgical Society. The estimated annual rupture rates of UCAs between 2003 and 2018 were calculated according to age-adjusted mortality rates of SAH and number of treated ruptured cerebral aneurysms (RCAs). We estimated trends in annual rupture rates using sensitivity analysis and assessed associations between estimated annual rupture rates and the prevalences of hypertension and current smoking. The estimated annual rupture rate of UCAs significantly decreased from 1.44 to 0.87% and from 0.92 to 0.76%, respectively, in terms of age-adjusted mortality rates of SAH and number of treated RCAs (p < 0.001). The range of changes in estimated annual rupture rates of UCAs was − 1.13%‒0.83%, representing a declining UCA trend of 88%. The estimated annual rupture rates of UCAs declined by 0.02–0.10% and 0.01–0.05% with every percent decrease in hypertension and current smoking prevalence, respectively. The estimated annual rupture rate of UCAs has recently decreased in Japan, possibly due to a decrease in the prevalence of hypertension rather than smoking.

Rupture rate

Subarachnoid hemorrhage

Nationwide registry

eng

Springer

This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10143-024-02587-7

This is not the published version. Please cite only the published version.

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[DOI] https://doi.org/10.1007/s10143-024-02587-7 isVersionOf

日本学術振興会

Japan Society for the Promotion of Science

[Crossref Funder] https://doi.org/10.13039/501100001691

くも膜下出血予防のレジストリーコホートと転帰改善のランダム化比較試験研究

A registry cohort study for prevention of subarachnoid hemorrhage and randomized controlled trial study of outcome improvement

23K08521