Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
Eur J Neurol. 2021 Jun;28(6):1984-1991. doi: 10.1111/ene.14812. Epub 2021 Mar 23.
Previous studies conducted elsewhere in the world have demonstrated an increase in the incidence of ischemic stroke (IS) in younger ages. We sought to determine stroke incidence and 28-day case-fatality rates in 15- to 54-year-old residents of Tartu, Estonia from 2013 to 2017.
All stroke cases that were the first ever in a lifetime (IS, nontraumatic intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) in 15- to 54-year-old residents of Tartu, Estonia were prospectively registered from January 1, 2013 to December 31, 2017. Several additional overlapping data sources were used for case ascertainment including other departments of the Tartu University Hospital and outpatient clinic, Estonian Cause of Death Registry, and the Estonian Electronic Health Record. All cases were thoroughly validated before inclusion.
We identified 110 cases (43.6% female) of first-ever stroke (IS 72.7%, ICH 12.7%, SAH 14.6%), out of which 85.5% were included prospectively. The mean age at onset was 44.3 ± 8.5 (SD) years. The mean age at onset was higher for men than for women (p = 0.046). The incidence of stroke standardized to the 1976 European standard population (EUR) was 46.1/100,000 (95% confidence interval [CI]: 37.4-54.8). IS incidence was 33.4/100,000 EUR (95% CI: 26-40.7). The total stroke incidence was higher in 45- to 54-year-old men than in women in the same age group (rate ratio, 2.24; 95% CI: 1.35-3.71). There were no more significant differences between sexes or age groups. The 28-day case-fatality rate was 10.9% for all strokes.
Our study shows higher crude incidence and case fatality of stroke in the young compared to studies from other high-income countries.
此前在世界其他地方进行的研究表明，缺血性卒中（IS）的发病率在年轻人中有所增加。我们旨在确定 2013 年至 2017 年爱沙尼亚塔尔图 15 至 54 岁居民的卒中发病率和 28 天病死率。
从 2013 年 1 月 1 日至 2017 年 12 月 31 日，前瞻性登记了 15 至 54 岁居住在爱沙尼亚塔尔图的首次出现的所有卒中病例（IS、非创伤性脑内出血 [ICH]和蛛网膜下腔出血 [SAH]）。还使用了其他几个重叠的数据来源来确定病例，包括塔尔图大学医院和门诊的其他科室、爱沙尼亚死因登记处和爱沙尼亚电子健康记录。在纳入之前，所有病例都经过了彻底的验证。
我们共确定了 110 例（43.6%为女性）首次发生的卒中（IS 72.7%、ICH 12.7%、SAH 14.6%），其中 85.5%是前瞻性纳入的。发病的平均年龄为 44.3±8.5（SD）岁。男性的发病年龄高于女性（p=0.046）。按 1976 年欧洲标准人口（EUR）标准化的卒中发病率为 46.1/100,000（95%置信区间[CI]：37.4-54.8）。IS 发病率为 33.4/100,000 EUR（95%CI：26-40.7）。在相同年龄组中，45-54 岁男性的总卒中发病率高于女性（发病率比，2.24；95%CI：1.35-3.71）。性别或年龄组之间没有其他显著差异。所有卒中的 28 天病死率为 10.9%。
与来自其他高收入国家的研究相比，我们的研究显示年轻人的卒中发病率和病死率更高。
