Nationwide Incidence of Terson Syndrome in Treated Subarachnoid Hemorrhage in South Korea: 2011-2015

Abstract

Purpose : To investigate the incidence and mortality of Terson syndrome in patients with treated subarachnoidal hemorrhage (SAH) in South Korea using National Health Insurance (NHI) database

Methods : For this nationwide population-based retrospective study, we used the national health claims database from 2011 to 2015, age of ≥ 18 years old, to identify patients diagnosed with treated SAH and Terson syndrome. Subjects with newly diagnosed non-traumatic SAH who underwent clipping or coiling, and newly diagnosed retinal or vitreous hemorrhage within 3 months of SAH were included and among them, subjects with newly diagnosed other ocular pathology causing retinal or vitreous hemorrhage were excluded. Nationwide incidence of Terson syndrome by age groups, gender, and treatment types per 100,000 person-years were calculated and the mortality among Terson syndrome and non-Terson syndrome were compared.

Results : We identified 22,864 treated SAH cases and 196 Terson syndrome cases among them during the study period. The incidence rate of Terson syndrome in treated SAH was 857.2 per 100,000 person-years (95% confidence interval [CI], 737.7-976.7) overall, and 1104.0 (95% CI 880.9-1327.1), and 713.3 (95% CI 576.0-850.6) per 100,000 person-years among male and female, respectively (male-to-female ratio, 1.548). There was no significant difference in incidence rate among treatment groups. The mortality rate of Terson syndrome in patients with treated SAH was 4.08% in total, and 5.38% and 2.91% in male and female, respectively (male-to-female ratio, 1.894). The mortality rate of non-Terson syndrome was 7.30%.

Conclusions : This was the first nationwide incidence study of Terson syndrome in all age groups using population-based database. The incidence and the mortality rate of Terson syndrome in treated SAH by gender was higher in male. The mortality rate of Terson syndrome in treated SAH was higher in male, and was not higher than in treated SAH without Terson syndrome.