Gender-related differences in aneurysmal subarachnoid hemorrhage: A hospital based study

Objectives: Aneurysmal subarachnoid hemorrhage (aSAH) is more common in women than in men. Despite its clinical relevance, knowledge about the potential gender differences in the clinical course and outcome of aSAH is sparse - we aimed at elucidating such differences.

Patients and methods: Retrospective cohort study including patients ≥18years of age with aSAH admitted to an interdisciplinary intensive-care center at the University Hospital of Bern (Switzerland).

Results: The study included 120 patients with aSAH. Sixty-nine percent of the enrolled patients were women. The women were older than men (mean [standard deviation] age 58±13years vs. 51±12years, P=0.006), and were increasingly overrepresented across increasing age-strata. Global disease severity at admission, measured by the APACHE II score, was higher in women than in men (median score 18 points [IQR 12-26] vs. 14 points [IQR 10-19], P=0.006). Men and women had similar medical histories and severity of aSAH. We found no evidence for major differences in the adopted aneurysm-securing strategy and intensive care interventions. At 6 months from aSAH, mortality was higher in women than men (28% vs. 16%), but this did not reach statistical significance (P=0.25). APACHE II, but not gender, was associated with unfavorable outcome at 6 months.

Conclusion: Women outnumbered men among aSAH patients, especially along increasing age strata, and had increased global disease severity on admission. No other significant differences between genders were found.