Management of patients with ruptured cerebral aneurysms in hospital population of Lithuania.

A retrospective analysis of ruptured cerebral aneurysms among the hospital population of Lithuania was performed. A total of 507 patients were enrolled in the study during a 5 year period. The unadjusted annual incidence of ruptured cerebral aneurysms was found to be 2.7/100,000 in the hospital population of Lithuania and 3.9/100,000 in the hospital population of the defined area of the city of Kaunas. Overall management results showed a 45. 6% good recovery and 31.6% death rate in this group of patients. Surgical results showed a 52.1% good outcome and 20.9% death rate. Despite the fact that the death rate according to the timing of surgery after the initial subarachnoid haemorrhage did not differ significantly (p >0.05) among early (0-3 days post SAH), moderate (4-7 days post SAH) and late (more than 7 days post SAH) surgery groups, it was found that 75 (14.8%) patients deteriorated while awaiting surgery. Initial bleeding together with rebleeding, medical complications and vasospasm were the main causes of death, constituting 61.3%, 18.1% and 9.4% of all deaths, respectively. The results of this study showed that the annual incidence of ruptured cerebral aneurysms in Lithuania is similar to that in other European countries except for Finland. Overall management results in the Lithuanian hospital population indicated only a slight improvement compared to management results of previous population-based studies in other countries.