Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.
Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Lund, Sweden.
Neuroepidemiology. 2022;56(3):174-182. doi: 10.1159/000524206. Epub 2022 Mar 23.
A decrease in ischemic stroke (IS) incidence has been observed in high income countries during the last decades. Whether this has influenced the occurrence of aphasia in IS is uncertain. We therefore examined the incidence rate and potentially related determinants of aphasia in IS.
We prospectively examined consecutive patients admitted to hospital with first-ever acute IS between March 1, 2017, and February 28, 2018, as part of the Lund Stroke Register (LSR) Study, comprising patients from the uptake area of Skåne University Hospital, Lund, Sweden. Patients were assessed with National Institutes of Health Stroke Scale (NIHSS) at stroke onset. Presence of aphasia was evaluated with NIHSS item 9 (language). We registered IS subtypes and risk factors. To investigate possible temporal changes in aphasia incidence, we made comparisons with corresponding LSR data from 2005 to 2006. Incidence rates were calculated and adjusted to the European Standard Population (ESP) and to the Swedish population.
Among 308 included IS patients, 30% presented with aphasia (n = 91; 95% CI: 25-35), a proportion of aphasia in IS that was similar to 2005-2006. The incidence rate of aphasia was 31 per 100,000 person-years adjusted to the ESP (95% CI: 25-38 per 100,000 person-years) corresponding to a significant decrease of 30% between 2005-2006 and 2017-2018. The decrease was significantly more pronounced in men. The initial severity of aphasia remained unchanged, with the majority of patients having severe to global aphasia. No significant differences between vascular stroke risk factors were noted among stroke patients with or without aphasia.
Even though the overall IS incidence rate has decreased during the first decades of the 21st century, the proportion of IS patients with aphasia at stroke onset remains stable at 30%. Aphasia continues to be an important symptom that needs to be considered in stroke care and rehabilitation.
在过去几十年中，高收入国家的缺血性中风（IS）发病率有所下降。这种情况是否会影响 IS 患者发生失语症尚不确定。因此，我们研究了 IS 中失语症的发病率和潜在相关决定因素。
我们前瞻性地检查了 2017 年 3 月 1 日至 2018 年 2 月 28 日期间因首次急性 IS 住院的连续患者，作为 Lund Stroke Register（LSR）研究的一部分，该研究包括来自瑞典斯科讷大学医院收治区域的患者。患者在发病时用国立卫生研究院卒中量表（NIHSS）进行评估。用 NIHSS 项目 9（语言）评估是否存在失语症。我们登记了 IS 亚型和危险因素。为了调查失语症发病率的可能时间变化，我们将其与 2005 年至 2006 年的相应 LSR 数据进行了比较。计算发病率并调整至欧洲标准人口（ESP）和瑞典人口。
在 308 名纳入的 IS 患者中，30%出现失语症（n = 91；95%CI：25-35），IS 患者的失语症比例与 2005-2006 年相似。调整至 ESP 的失语症发病率为 31/100,000 人年（95%CI：25-38/100,000 人年），与 2005-2006 年至 2017-2018 年期间的 30%显著下降相关。这种下降在男性中更为明显。失语症的初始严重程度保持不变，大多数患者为重度至完全性失语症。在有或没有失语症的中风患者中，血管性中风危险因素之间没有显著差异。
尽管在 21 世纪的头几十年中，IS 的总体发病率有所下降，但发病时伴有失语症的 IS 患者比例仍稳定在 30%。失语症仍然是一个重要的症状，需要在中风护理和康复中考虑。
