Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta (T.-M.P., B.K., L.S.), Alberta Health Services, Edmonton and Calgary, Canada.
Strategic Clinical Networks (N.X.T., T.W.), Alberta Health Services, Edmonton and Calgary, Canada.
Stroke. 2021 Jan;52(2):573-581. doi: 10.1161/STROKEAHA.120.032028. Epub 2021 Jan 7.
There are challenges in comparability when using existing life lost measures to examine long-term trends in premature mortality. To address this important issue, we have developed a novel measure termed average lifespan shortened (ALSS). In the present study, we used the ALSS measure to describe temporal changes in premature mortality due to stroke in the Canadian population from 1990 to 2015.
Mortality data for stroke were obtained from the World Health Organization mortality database. Years of life lost was calculated using Canadian life tables. ALSS was calculated as the ratio of years of life lost in relation to the expected lifespan.
Over a 25-year timeframe, the age-standardized rates adjusted to the World Standard Population for deaths from all strokes and stroke types substantially decreased in both sexes. The ALSS measure indicated that men who died of stroke lost 12.1% of their lifespan in 1990 and 11.4% in 2015, whereas these values among women were 11.1% and 10.0%, respectively. Patients with subarachnoid hemorrhagic stroke lost the largest portion whereby both sexes lost about one-third of their lifespan in 1990 and one-fourth in 2015. Men with intracerebral hemorrhagic stroke lost around 18% of their lifespan in 1990 and 14% in 2015 as compared to women who lost about 16% and 12% over the same timeframe. The loss of lifespan for patients with ischemic stroke and other stroke types combined was relatively stable at about 10% throughout the study period.
Our study demonstrated a modest improvement in lifespan among patients with stroke in Canada between 1990 and 2015. Our novel ALSS measure provides intuitive interpretation of temporal changes in lifespan among patients with stroke and helps to enhance our understanding of the burden of strokes in the Canadian population.
使用现有的生命损失衡量标准来研究早期死亡的长期趋势存在可比性方面的挑战。为了解决这个重要问题，我们开发了一种新的衡量标准，称为平均寿命缩短（ALSS）。本研究使用 ALSS 衡量标准来描述加拿大人群中 1990 年至 2015 年因中风导致的过早死亡的时间变化。
从世界卫生组织死亡率数据库中获取中风的死亡率数据。使用加拿大生命表计算生命损失年数。ALSS 是通过将生命损失年数与预期寿命进行比较得出的比值。
在 25 年的时间范围内，所有类型中风和中风类型的年龄标准化死亡率调整为世界标准人口后，在两性中均大幅下降。ALSS 衡量标准表明，1990 年死于中风的男性失去了 12.1%的寿命，而 2015 年这一比例为 11.4%；女性分别为 11.1%和 10.0%。蛛网膜下腔出血的患者损失的寿命最长，两性在 1990 年损失了大约三分之一的寿命，而在 2015 年损失了四分之一。1990 年，男性脑出血患者失去了约 18%的寿命，而 2015 年则失去了 14%；而女性在同一时间段内分别失去了约 16%和 12%的寿命。缺血性中风和其他中风类型患者的寿命损失在整个研究期间相对稳定，约为 10%。
本研究表明，1990 年至 2015 年间，加拿大中风患者的寿命略有改善。我们新的 ALSS 衡量标准为中风患者的寿命变化提供了直观的解释，有助于我们更好地了解加拿大人口中中风的负担。
