Division of Neurology, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Medical Research Center, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
PLoS One. 2022 Nov 16;17(11):e0277296. doi: 10.1371/journal.pone.0277296. eCollection 2022.
Chinese populations have been reported higher incidence of all strokes and intracerebral hemorrhage. However, few large-scale studies have evaluated changes of stroke epidemiology in the 21st century.
We explored the rates of incidence of all first-ever strokes, subtypes, and 1-month case fatality by using data from the Taiwan National Health Insurance Research Database since 2004. Also, we investigated sex differences in stroke. Time-trend analysis was performed for incidence and case fatality rates of all strokes and subtypes in both sexes.
The age-adjusted incidence of all strokes per 100,000 person-years decreased by 16%, from 251 (95% confidence interval [CI] 249-253) in 2004 to 210 (95% CI 209-212) in 2011 (p<0.001); it was always higher in Chinese men than in women. Among pathological subtypes, the incidence of intracerebral hemorrhage markedly decreased by 26% over the years (p<0.001), while that of ischemic stroke slightly decreased by 8%. However, when stratified by sex, the incidence of ischemic stroke decreased significantly in only women, not in men (men: p = 0.399, women: p = 0.004). Regarding the incidence of subarachnoid hemorrhage, it remained unchanged. Furthermore, the rate of 1-month case fatality decreased significantly for all strokes in both sexes (p<0.001).
In Taiwan, the incidence rate of first-ever stroke decreased in both Chinese men and women in the early 21st century. Men had a higher incidence rate than women. Furthermore, a marked decrease was noted in the incidence of intracerebral hemorrhage, while a slight decrease was noted in that of ischemic stroke; however, the decreased incidence of ischemic stroke was significant in only women.
据报道，中国人群的所有中风和脑出血发病率都较高。然而，很少有大规模研究评估 21 世纪中风流行病学的变化。
我们利用 2004 年以来台湾全民健康保险研究数据库的数据，探讨了所有首次发生的中风、亚型以及 1 个月病死率的发生率。此外，我们还研究了中风的性别差异。对男女中风的发生率和病死率进行了时间趋势分析。
校正年龄后的所有中风发病率（每 10 万人年）下降了 16%，从 2004 年的 251（95%置信区间 [CI] 249-253）降至 2011 年的 210（95% CI 209-212）（p<0.001）；中国男性的发病率一直高于女性。在病理亚型中，脑出血的发病率在这几年中显著下降了 26%（p<0.001），而缺血性中风的发病率则略有下降 8%。然而，按性别分层时，仅女性的缺血性中风发病率显著下降，男性则没有（男性：p = 0.399，女性：p = 0.004）。蛛网膜下腔出血的发病率则保持不变。此外，男女所有中风的 1 个月病死率均显著下降（p<0.001）。
在台湾，21 世纪初中国男女首次中风的发病率均有所下降。男性的发病率高于女性。此外，脑出血的发病率显著下降，而缺血性中风的发病率略有下降；然而，缺血性中风发病率的下降仅在女性中显著。
