Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Int J Stroke. 2021 Oct;16(7):855-862. doi: 10.1177/1747493020979379. Epub 2020 Dec 13.
Recent studies reported increasing trends in hospitalization of stroke patients aged 35-64 years.
To examine changes in risk factor profiles among patients aged 35-64 years hospitalized with acute ischemic stroke between 2006 and 2017 in the United States.
We used data from the National Inpatient Sample of the Healthcare Cost and Utilization Project from 2006 through 2017. Principal ICD-9-CM/ICD-10-CM codes were used to identify acute ischemic stroke hospitalizations, and secondary codes were used to identify the presence of four major stroke risk factors: hypertension, diabetes, lipid disorders, and tobacco use. We used the relative percent change to assess the changes in the prevalence of risk profile between 2006-2007 and 2016-2017 and linear regression models to obtain the p values for the overall trends across six time periods.
Approximately 1.5 million acute ischemic stroke hospitalizations occurred during 2006-2017. The prevalence of having all four risk factors increased from 4.1% in 2006-2007 to 9.1% in 2016-2017 (relative percent change 122.0%, p < 0.001 for trend), prevalence of any three risk factors increased from 24.5% to 33.8% (relative percent change 38.0%, p < 0.001). Prevalence of only two risk factors decreased from 36.1% to 32.7% (p < 0.001), only one risk factor decreased from 25.2% to 18.1% (p < 0.001), and absence of risk factors decreased from 10.1% to 6.2% (p < 0.001). The most prevalent triad of risk factors was hypertension, diabetes, and lipid disorders (14.3% in 2006-2007 and 19.8% in 2016-2017), and the most common dyad risk factors was hypertension and lipid disorders (12.6% in 2006-2007 and 11.9% in 2016-2017).
The prevalence of hospitalized acute ischemic stroke patients aged 35-64 years with all four or any three of four major stroke risk factors increased by 122% and 38%, while those with only one risk factor or no risk factor has declined by 28% and 39%, respectively, from 2006 to 2017. Younger adults are increasingly at higher risk for stroke from preventable and treatable risk factors. This growing public health problem will require clinicians, healthcare systems, and public health efforts to implement more effective prevention strategies among this population.
最近的研究报告显示，35-64 岁年龄段的脑卒中患者住院人数呈上升趋势。
在美国，研究 2006 年至 2017 年期间 35-64 岁因急性缺血性脑卒中住院患者的风险因素谱变化情况。
我们使用了 2006 年至 2017 年期间医疗保健成本和利用项目的国家住院患者样本数据。主要的 ICD-9-CM/ICD-10-CM 编码用于识别急性缺血性脑卒中住院患者，次要编码用于识别四大脑卒中风险因素：高血压、糖尿病、血脂异常和吸烟。我们使用相对百分比变化来评估 2006-2007 年和 2016-2017 年之间风险特征患病率的变化，并用线性回归模型获得六个时间段整体趋势的 p 值。
2006-2017 年期间约有 150 万例急性缺血性脑卒中住院患者。四种风险因素全部存在的比例从 2006-2007 年的 4.1%增加到 2016-2017 年的 9.1%（相对百分比变化 122.0%，p<0.001 表示趋势），三种风险因素存在的比例从 24.5%增加到 33.8%（相对百分比变化 38.0%，p<0.001）。仅存在两种风险因素的比例从 36.1%下降到 32.7%（p<0.001），仅存在一种风险因素的比例从 25.2%下降到 18.1%（p<0.001），不存在风险因素的比例从 10.1%下降到 6.2%（p<0.001）。最常见的三联风险因素是高血压、糖尿病和血脂异常（2006-2007 年为 14.3%，2016-2017 年为 19.8%），最常见的二联风险因素是高血压和血脂异常（2006-2007 年为 12.6%，2016-2017 年为 11.9%）。
2006 年至 2017 年期间，患有全部四种或四种主要脑卒中风险因素中三种的 35-64 岁急性缺血性脑卒中住院患者的比例分别增加了 122%和 38%，而仅存在一种风险因素或不存在风险因素的患者比例分别下降了 28%和 39%。年轻成年人因可预防和可治疗的风险因素而面临更高的脑卒中风险。这一日益严重的公共卫生问题将需要临床医生、医疗保健系统和公共卫生部门在这一人群中实施更有效的预防策略。
