Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Neuroepidemiology. 2017;48(3-4):111-118. doi: 10.1159/000478016. Epub 2017 Jun 22.
BACKGROUND/AIMS: Administrative data are widely used to monitor epidemiological trends in stroke and outcomes; yet there is scant empirical guidance on how to best differentiate incident from recurrent stroke.
We identified all hospital admissions in New South Wales, Australia, with a principal stroke diagnosis from July 1, 2013 to June 30, 2014, linked to 12 years of previous admissions. We calculated the proportion of cases identified with a prior stroke to determine the number of years of look-back required to minimise misclassification of incident and recurrent strokes.
Using the maximum available look-back period of 12 years, 1,171 out of 8,364 eligible stroke cases (14.0%) had a stroke history. A 1-year look-back period identified only 25.1% of these patients and 1 in 10 stroke cases were misclassified as incident. With a 10-year clearance period, less than 1 in 100 stroke cases were misclassified as incident. The risk of misclassification was lower in patients younger than 65 years and in those with haemorrhagic stroke.
Hospital administrative data sets linked to prior admissions can be used to distinguish recurrent from incident stroke. The risk of misclassifying recurrent stroke cases as incident events is negligible with a look-back period of 10 years.
背景/目的：行政数据被广泛用于监测中风的流行病学趋势和结果；然而，关于如何最好地区分首发和复发性中风，几乎没有经验性的指导。
我们在 2013 年 7 月 1 日至 2014 年 6 月 30 日期间，在澳大利亚新南威尔士州确定了所有以主要中风诊断入院的患者，并与 12 年前的住院记录相联系。我们计算了有既往中风史的病例比例，以确定最小化首发和复发性中风错误分类所需的回顾年限。
使用最长的可用回顾期 12 年，在 8364 例合格的中风病例中，有 1171 例（14.0%）有中风史。1 年的回顾期仅识别出其中 25.1%的患者，每 10 例中风病例中就有 1 例被错误地归类为首发。10 年的清除期内，不到 100 例中风病例被错误地归类为首发。在年龄小于 65 岁的患者和出血性中风患者中，错误分类的风险较低。
与既往入院记录相联系的医院行政数据集可用于区分复发性和首发中风。通过 10 年的回顾期，将复发性中风病例错误地归类为首发事件的风险可以忽略不计。
