Clissold Benjamin B, Sundararajan Vijaya, Cameron Peter, McNeil John
Stroke Unit, Monash Medical Centre, Clayton, VIC, Australia.
Stroke and Ageing Research Group, Department of Medicine, Monash University, Clayton, VIC, Australia.
Front Neurol. 2017 May 4;8:180. doi: 10.3389/fneur.2017.00180. eCollection 2017.
Evidence of a decline in the incidence of stroke has emerged from population-based studies. These have included retrospective and prospective cohorts. However, in Australia and other countries, government bodies and stroke foundations predict a rise in the prevalence of stroke that is anticipated to increase the burden of stroke across the entire domain of care. This increase in prevalence must be viewed as different from the decline in incidence being observed, a measure of new stroke cases. In Victoria, all public emergency department visits and public and private hospital admissions are reported to the Department of Health and Human Services and include demographic, diagnostic, and procedural/treatment information.
We obtained data from financial years 1997/1998 to 2007/2008 inclusive, for all cases with a primary stroke diagnosis (ICD-10-AM categories) with associated data fields. Incident cases were established by using a 5-year clearance period.
From 2003/2004 to 2007/2008 inclusive, there were 53,425 patients with a primary stroke or TIA diagnosis. The crude incident stroke rate for first ever stroke was 211 per 100,000 per year (95% CI 205-217) [females-205 per 100,000 per year (95% CI 196-214) and males-217 per 100,000 per year (95% CI 210-224)]. The overall stroke rates were seen to significantly decline over the period [males (per 100,000 per year) 227 in 2003/2004 to 202 in 2007/2008 ( = 0.0157) and females (per 100,000 per year) 214 in 2003/2004 to 188 in 2007/2008 ( = 0.0482)]. Ischemic stroke rates also appeared to decline; however, this change was not significant.
These results demonstrate a significant decline in stroke incidence during the study period and may suggest evidence for effectiveness of primary and secondary prevention strategies in cerebrovascular risk factor management.
基于人群的研究已出现中风发病率下降的证据。这些研究包括回顾性和前瞻性队列研究。然而，在澳大利亚和其他国家，政府机构和中风基金会预测中风患病率将会上升，预计这将增加整个护理领域的中风负担。这种患病率的上升必须被视为与所观察到的发病率下降（一种新中风病例的衡量指标）不同。在维多利亚州，所有公共急诊科就诊以及公立和私立医院的入院情况都会上报给卫生与公众服务部，其中包括人口统计学、诊断以及程序/治疗信息。
我们获取了1997/1998财政年度至2007/2008财政年度（含）所有原发性中风诊断（ICD - 10 - AM类别）病例及其相关数据字段的数据。通过使用5年的清除期来确定新发病例。
从2003/2004年至2007/2008年（含），有53425例患者被诊断为原发性中风或短暂性脑缺血发作（TIA）。首次中风的粗发病率为每年每10万人211例（95%可信区间205 - 217）[女性为每年每10万人205例（95%可信区间196 - 214），男性为每年每10万人217例（95%可信区间210 - 224）]。在此期间总体中风率显著下降[男性（每年每10万人）从2003/2004年的227例降至2007/2008年的202例（P = 0.0157），女性（每年每10万人）从2003/2004年的2l4例降至2007/2008年的188例（P = 0.0482）]。缺血性中风率似乎也有所下降；然而，这种变化并不显著。
这些结果表明在研究期间中风发病率显著下降，这可能为脑血管危险因素管理中一级和二级预防策略的有效性提供了证据。
