Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
BMJ Open. 2020 Oct 8;10(10):e039533. doi: 10.1136/bmjopen-2020-039533.
We aimed to compare the incidence, subtypes and aetiology of stroke, and in-hospital death due to stroke, between Aboriginal and non-Aboriginal people in Central Australia, a remote region of Australia where a high proportion Aboriginal people reside (40% of the population). We hypothesised that the rates of stroke, particularly in younger adults, would be greater in the Aboriginal population, compared with the non-Aboriginal population; we aimed to elucidate causes for any identified disparities.
A retrospective population-based study of patients hospitalised with stroke within a defined region from 1 January 2011 to 31 December 2014.
Alice Springs Hospital, the only neuroimaging-capable acute hospital in Central Australia, serving a network of 50 healthcare facilities covering 672 000 km.
161 residents (63.4% Aboriginal) of the catchment area admitted to hospital with stroke.
Rates of first-ever stroke, overall (all events) stroke and in-hospital death.
Of 121 residents with first-ever stroke, 61% identified as Aboriginal. Median onset-age (54 years) was 17 years younger in Aboriginal patients (p<0.001), and age-standardised stroke incidence was threefold that of non-Aboriginal patients (153 vs 51 per 100 000, incidence rate ratio 3.0, 95% CI 2 to 4). The rate ratios for the overall rate of stroke (first-ever and recurrent) were similar. In Aboriginal patients aged <55 years, the incidence of ischaemic stroke was 14-fold greater (95% CI 4 to 45), and intracerebral haemorrhage 19-fold greater (95% CI 3 to 142) than in non-Aboriginal patients. Crude prevalence of diabetes mellitus (70.3% vs 34.0%, p<0.001) and hypercholesterolaemia (68.9% vs 51.1%, p=0.049) was greater, and age-standardised in-hospital deaths were fivefold greater (35 vs 7 per 100 000, 95% CI 2 to 11) in Aboriginal patients than in non-Aboriginal patients.
Stroke incidence (both subtypes) and in-hospital deaths for remote Aboriginal Australians are dramatically greater than in non-Aboriginal people, especially in patients aged <55 years.
我们旨在比较澳大利亚中部偏远地区（该地区有 40%的人口为原住民）原住民和非原住民人群中，中风的发病率、亚型和病因，以及中风导致的住院死亡率。我们假设，与非原住民相比，原住民人群中风的发病率，特别是在年轻成年人中，将会更高；我们旨在阐明任何已确定的差异的原因。
2011 年 1 月 1 日至 2014 年 12 月 31 日期间，在一个明确界定的地区内，对因中风住院的患者进行了一项基于人群的回顾性研究。
爱丽丝泉医院，是澳大利亚中部唯一一家具备神经影像学能力的急性医院，服务于一个拥有 50 家医疗机构的网络，覆盖面积达 672000 平方公里。
161 名居住在该流域并因中风住院的居民（63.4%为原住民）。
首次中风、总体（所有事件）中风和住院期间死亡的发生率。
在 121 名首次发生中风的居民中，61%被认定为原住民。原住民患者的中位发病年龄（54 岁）比非原住民患者年轻 17 岁（p<0.001），且标准化发病率是非原住民患者的三倍（153 比 51 每 100000 人，发病率比 3.0，95%置信区间 2 至 4）。总体中风（首次发生和复发）的发病率比值相似。在年龄<55 岁的原住民患者中，缺血性中风的发病率是 14 倍（95%置信区间 4 至 45），脑出血的发病率是 19 倍（95%置信区间 3 至 142），而非原住民患者。粗患病率糖尿病（70.3%比 34.0%，p<0.001）和高胆固醇血症（68.9%比 51.1%，p=0.049）更高，标准化的住院死亡率是原住民患者的五倍（35 比每 100000 人 7 例，95%置信区间 2 至 11），而非原住民患者。
偏远地区的澳大利亚原住民的中风发病率（包括两种类型）和住院死亡率都远远高于非原住民，尤其是在年龄<55 岁的患者中。
