Queen Elizabeth Hospital, Adelaide, Australia.
Stroke. 2013 May;44(5):1226-31. doi: 10.1161/STROKEAHA.113.675140. Epub 2013 Mar 12.
Stroke incidence rates are in flux worldwide because of evolving risk factor prevalence, risk factor control, and population aging. Adelaide Stroke Incidence Study was performed to determine the incidence of strokes and stroke subtypes in a relatively elderly population of 148 000 people in the Western suburbs of Adelaide.
All suspected strokes were identified and assessed in a 12-month period from 2009 to 2010. Standard definitions for stroke and stroke fatality were used. Ischemic stroke pathogenesis was classified by the Trial of ORG 10172 in Acute Stroke Treatment criteria.
There were 318 stroke events recorded in 301 individuals; 238 (75%) were first-in-lifetime events. Crude incidence rates for first-ever strokes were 161 per 100 000 per year overall (95% confidence interval [CI], 141-183), 176 for men (95% CI, 147-201), and 146 for women (95% CI, 120-176). Adjusted to the world population rates were 76 overall (95% CI, 59-94), 91 for men (95% CI, 73-112), and 61 for women (95% CI, 47-78). The 28-day case fatality rate for first-ever stroke was 19% (95% CI, 14-24); the majority were ischemic (84% [95% CI, 78-88]). Intracerebral hemorrhage comprised 11% (8-16), subarachnoid hemorrhage 3% (1-6), and 3% (1-6) were undetermined. Of the 258 ischemic strokes, 42% (95% CI, 36-49) were of cardioembolic pathogenesis. Atrial fibrillation accounted for 36% of all ischemic strokes, of which 85% were inadequately anticoagulated.
Stroke incidence in Adelaide has not increased compared with previous Australian studies, despite the aging population. Cardioembolic strokes are becoming a higher proportion of all ischemic strokes.
由于风险因素流行率、风险因素控制和人口老龄化的不断变化，全球范围内的中风发病率正在发生变化。阿德莱德中风发病率研究旨在确定阿德莱德西郊 148000 名相对老年人中中风和中风亚型的发病率。
在 2009 年至 2010 年的 12 个月期间，对所有疑似中风患者进行了识别和评估。使用中风和中风死亡率的标准定义。通过急性中风治疗试验中的 ORG 10172 标准对缺血性中风发病机制进行分类。
在 301 名患者中记录了 318 例中风事件；238 例（75%）为首次终身事件。首次发生中风的粗发病率为每年每 100000 人 161 例（95%置信区间[CI]，141-183），男性为 176 例（95%CI，147-201），女性为 146 例（95%CI，120-176）。调整后的世界人口发病率为 76 例（95%CI，59-94），男性为 91 例（95%CI，73-112），女性为 61 例（95%CI，47-78）。首次中风的 28 天病死率为 19%（95%CI，14-24）；大多数为缺血性（84%[95%CI，78-88]）。脑出血占 11%（8-16），蛛网膜下腔出血占 3%（1-6），3%（1-6）未确定。在 258 例缺血性中风中，42%（95%CI，36-49）为心源性栓塞性发病机制。房颤占所有缺血性中风的 36%，其中 85%抗凝治疗不足。
尽管人口老龄化，但与之前的澳大利亚研究相比，阿德莱德的中风发病率并未增加。心源性栓塞性中风在所有缺血性中风中的比例越来越高。
