Department of Neurology and Neurosurgery, Faculty of Medicine, University of Tartu, Tartu, Estonia.
Int J Stroke. 2023 Apr;18(4):462-468. doi: 10.1177/17474930221125345. Epub 2022 Sep 14.
Having a stroke at a young age has a huge socioeconomic impact. Data on the trends of stroke incidence in young adults from prospective population-based studies are scarce.
The aim of this study was to analyze the trends in stroke incidence in 15- to 54-year-old residents of Tartu, Estonia from 1991 to 2017.
Three population-based studies with identical study protocols determining the incidence of first-ever stroke have previously been conducted in Tartu, Estonia (1991-1993, 2001-2003, and 2013-2017). All residents of Tartu with first-ever stroke (ischemic stroke, spontaneous intracerebral hemorrhage, and subarachnoid hemorrhage) who were hospitalized to the Department of Neurology, Tartu University Hospital in respective study periods were included prospectively. Overlapping data sources for case ascertainment were used to include both hospitalized and non-hospitalized cases. Trends in first-ever stroke incidence in 15- to 54-year-old residents of Tartu were calculated and compared using rate ratio (RR).
Altogether 259 strokes were identified. From 1991 to 2017, the proportion of women increased from 38.3% to 43.6%. Mean age at onset in women decreased from 46.9 (standard deviation (SD): 7.3) to 42.6 (SD: 8.9). Overall crude incidence rates per 100,000 decreased significantly from 1991 to 2003 (from 57.2 (95% confidence interval (CI): 46.9-69.1) to 35.7 (95% CI: 25.7-48.3)); RR: 0.62 (95% CI: 0.44-0.89). While also present in women, the decrease was most notable in 45- to 54-year-old men (RR: 0.55 (95% CI: 0.30-0.99)). In 35- to 44-year-old men, the incidence rates decreased significantly from 2001 to 2017 (RR: 0.37 (95% CI: 0.14-0.99)).
The overall first-ever stroke incidence rates decreased from 1991 to 2003 and remained stable thereafter.
年轻时发生中风会产生巨大的社会经济影响。关于前瞻性人群为基础的研究中年轻成年人中风发病率的趋势数据很少。
本研究旨在分析 1991 年至 2017 年爱沙尼亚塔尔图 15 至 54 岁居民中风发病率的趋势。
此前在爱沙尼亚塔尔图进行了三项基于人群的研究，使用相同的研究方案确定首次中风的发病率（1991-1993 年、2001-2003 年和 2013-2017 年）。在各自的研究期间，所有首次发生中风（缺血性中风、自发性脑内出血和蛛网膜下腔出血）的塔尔图居民被收入前瞻性研究。为了确定病例，使用了重叠的数据源，包括住院和非住院病例。通过比率比（RR）计算并比较了塔尔图 15 至 54 岁居民首次中风发病率的趋势。
共发现 259 例中风。1991 年至 2017 年期间，女性比例从 38.3%增加到 43.6%。女性发病年龄从 46.9（标准差（SD）：7.3）降至 42.6（SD：8.9）。总体粗发病率每 10 万人显著下降，从 1991 年至 2003 年（从 57.2（95%置信区间（CI）：46.9-69.1）降至 35.7（95% CI：25.7-48.3））；RR：0.62（95% CI：0.44-0.89）。虽然在女性中也存在这种情况，但在 45 至 54 岁的男性中最为显著（RR：0.55（95% CI：0.30-0.99））。在 35 至 44 岁的男性中，发病率从 2001 年至 2017 年显著下降（RR：0.37（95% CI：0.14-0.99））。
1991 年至 2003 年，首次中风的总体发病率下降，此后保持稳定。
