From the Department of Clinical Epidemiology (N.S., K.A., E.H.-P., K.J.R., V.W.H., H.T.S.) and Department of Clinical Biochemistry (K.A.), Thrombosis and Haemostasis Research Unit, Aarhus University Hospital; National Institute of Public Health (N.S., L.C.T.), University of Southern Denmark, Copenhagen; Department of Epidemiology (K.J.R., H.T.S.), Boston University School of Public Health, MA; RTI Health Solutions (K.J.R.), Research Triangle Institute, Research Triangle Park, NC; and Department of Epidemiology and Population Health (V.W.H., H.T.S.) and Department of Neurology and Neurological Sciences, Stanford University, CA.
Neurology. 2021 Mar 30;96(13):e1711-e1723. doi: 10.1212/WNL.0000000000011636. Epub 2021 Feb 10.
To investigate the extent to which the incidence and mortality of a first-time stroke among younger and older adults changed from 2005 to 2018 in Denmark using nationwide registries.
We used the Danish Stroke Registry and the Danish National Patient Registry to identify patients 18 to 49 years of age (younger adults) and those ≥50 years of age (older adults) with a first-time ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. We computed age-standardized incidence rates and 30-day and 1-year mortality risks separately for younger and older adults and according to smaller age groups, stroke subtype, sex, and severity (Scandinavian Stroke Scale score). Average annual percentage changes (AAPCs) were computed to assess temporal trends.
We identified 8,680 younger adults and 105,240 older adults with an ischemic stroke or intracerebral hemorrhage. The incidence rate per 100,000 person-years of ischemic stroke (20.8 in 2005 and 21.9 in 2018, AAPC -0.6 [95% confidence interval (CI) -1.5 to 0.3]) and intracerebral hemorrhage (2.2 in 2005 and 2.5 in 2018, AAPC 0.6 [95% CI -1.0 to 2.3]) remained steady in younger adults. In older adults, rates of ischemic stroke and intracerebral hemorrhage declined, particularly in those ≥70 years of age. Rates of subarachnoid hemorrhage declined, but more so in younger than older adults. Stroke mortality declined over time in both age groups, attributable largely to declines in the mortality after severe strokes. Most trends were similar for men and women.
The incidence of ischemic stroke and intracerebral hemorrhage was steady in younger adults from 2005 to 2018, while it dropped in adults >70 years of age. Stroke mortality declined during this time.
利用丹麦全国性注册系统，调查丹麦年轻人和老年人首次中风的发病率和死亡率在 2005 年至 2018 年间的变化情况。
我们使用丹麦中风登记系统和丹麦全国患者登记系统，确定年龄在 18 至 49 岁（年轻人）和≥50 岁（老年人）之间的首次缺血性中风、脑出血或蛛网膜下腔出血患者。我们分别计算了年轻人和老年人的年龄标准化发病率以及 30 天和 1 年的死亡率风险，并按年龄较小的亚组、中风亚型、性别和严重程度（斯堪的纳维亚中风量表评分）进行了分类。计算平均年百分比变化（AAPC）以评估时间趋势。
我们共确定了 8680 名年轻人和 105240 名老年人患有缺血性中风或脑出血。每 100000 人年的缺血性中风（2005 年为 20.8，2018 年为 21.9，AAPC-0.6[95%置信区间（CI）-1.5 至 0.3]）和脑出血（2005 年为 2.2，2018 年为 2.5，AAPC 0.6[95%CI-1.0 至 2.3]）的发病率在年轻人中保持稳定。在老年人中，缺血性中风和脑出血的发病率下降，尤其是≥70 岁的老年人。蛛网膜下腔出血的发病率下降，但在年轻人中比老年人中更为明显。在两个年龄组中，中风死亡率随时间下降，主要归因于严重中风后死亡率的下降。大多数趋势在男性和女性中相似。
2005 年至 2018 年，年轻人缺血性中风和脑出血的发病率保持稳定，而≥70 岁的成年人发病率则下降。在此期间，中风死亡率下降。
