From the Stanley Steyer School of Health Professions (S.K.)
Sackler Faculty of Medicine (S.K., J.Y.S., N.M.B., D.T.), Tel Aviv University, Israel.
Stroke. 2018 Jun;49(6):1348-1354. doi: 10.1161/STROKEAHA.117.019822. Epub 2018 May 2.
Stroke is a leading cause of morbidity and disability. We assessed trends in rates of hospitalized stroke and stroke severity on admission in a prospective national registry of stroke from 2004 to 2013.
All 6693 acute ischemic strokes and intracerebral hemorrhage in the National Acute Stroke Israeli participants ≥20 years old were included. Data were prospectively collected in 2004 (February-March), 2007 (March-April), 2010 (April-May), and 2013 (March-April). Rates of hospitalized stroke from 2004 to 2013 were studied using generalized linear models assuming a quasi-Poisson error distribution with a log link. Stroke severity on admission was determined using the National Institutes of Health Stroke Scale score and trends were studied. Analysis was performed for stroke overall and by sex and age-group as well as by stroke type.
Estimated average annual rates of hospitalized stroke decreased from 24.9/10 000 in 2004 to 19.5/10 000 in 2013. The age and sex-adjusted rates ratio (95% confidence interval) for hospitalized stroke overall was 0.82 (0.76-0.89) for 2007, 0.71 (0.65-0.77) for 2010, and 0.72 (0.66-0.78) for 2013 compared with 2004. Severity on admission decreased over time: rates (95% confidence interval) of severe stroke (National Institutes of Health Stroke Scale score of ≥11) decreased from 27% (25%-29%) in 2004 to 19% (17%-21%) in 2013, whereas rates (95% confidence interval) of minor stroke (National Institutes of Health Stroke Scale score of ≤5) increased from 46% (44%-49%) in 2004 to 60% (57%-62%) in 2013 (<0.0001). Findings were consistent by sex, age-group, and stroke type.
Based on our national data, rates of hospitalized stroke and severity of stroke on admission have decreased from 2004 to 2013 overall and by stroke type, in men and women. Despite the observed declines in rates and severity, stroke continues to place a considerable burden to the Israeli health system.
卒中是发病率和致残率的主要原因。我们评估了 2004 年至 2013 年期间一项前瞻性全国卒中登记研究中住院卒中发病率和入院时卒中严重程度的变化趋势。
纳入了以色列全国急性卒中登记研究中年龄≥20 岁的 6693 例急性缺血性卒中和颅内出血患者。数据于 2004 年（2 月至 3 月）、2007 年（3 月至 4 月）、2010 年（4 月至 5 月）和 2013 年（3 月至 4 月）前瞻性收集。采用广义线性模型估计 2004 年至 2013 年住院卒中发病率，假设准泊松误差分布和对数链接。使用国立卫生研究院卒中量表评分来确定入院时的卒中严重程度，并研究其变化趋势。分析总体卒中以及按性别和年龄组以及按卒中类型进行分析。
估计的平均年住院卒中发病率从 2004 年的 24.9/10 000 下降到 2013 年的 19.5/10 000。总体卒中的年龄和性别调整发病率比值（95%置信区间），2007 年为 0.82（0.76-0.89），2010 年为 0.71（0.65-0.77），2013 年为 0.72（0.66-0.78），与 2004 年相比。入院时的严重程度随时间下降：严重卒中（国立卫生研究院卒中量表评分≥11）的发生率（95%置信区间）从 2004 年的 27%（25%-29%）下降到 2013 年的 19%（17%-21%），而轻度卒中（国立卫生研究院卒中量表评分≤5）的发生率（95%置信区间）从 2004 年的 46%（44%-49%）增加到 2013 年的 60%（57%-62%）（<0.0001）。在性别、年龄组和卒中类型方面均观察到一致的结果。
基于我们的全国数据，总体而言，2004 年至 2013 年期间，按卒中类型、性别划分的住院卒中发病率和入院时卒中严重程度均有所下降。尽管观察到发生率和严重程度下降，但卒中仍然给以色列卫生系统带来了相当大的负担。
