Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
First Medical College, Chongqing Medical University, Chongqing, China.
Cerebrovasc Dis. 2024;53(2):198-204. doi: 10.1159/000531488. Epub 2023 Jul 12.
Stroke has become a major disease that threatens the global population's health and is a major public health problem that needs to be solved in China. Therefore, it is essential to analyze the trend of the mortality of stroke and its epidemic characteristic of stroke death.
Death cases of stroke were reported to the national death registry system by the medical staff of all medical institutions, and the population data every year were obtained from District or County's Statistic Bureau in Chongqing. They were analyzed to calculate the mortality, age-standardized mortality rate by Chinese standardization population (ASMRC), age-specific mortality, proportion, and annual percent of change (APC) according to the ICD-10 code. ASMRC was based on the standard population of the 6th census in China, 2010. The stroke mortality of each subgroup was compared using the χ2 test. Trend analysis was presented by APC.
The crude mortality of stroke increased from 96.29 per 100,000 in 2012 to 115.93 per 100,000 significantly, with the APC of 2.02% (t = 2.82, p = 0.022) in Chongqing. ASMRC of stroke was 56.47 per 100,000 in 2012 and 54.70 per 100,000 in 2021, and its trend change was stable (APC = -0.01, t = 0.07, p = 0.947). The crude mortality of stroke in males was higher than that in females every year (p < 0.05). The death proportion of intracerebral hemorrhage dwindled from 60.53% in 2012 to 49.88% in 2021, whereas the death proportion of ischemic stroke increased from 20.92% in 2012 to 39.96% in 2021. The average age of stroke death was delayed from 73.43 years old in 2012 to 76.52 years old in 2021 significantly (t = 18.12, p < 0.001). The percentage of stroke death at home increased from 75.23% in 2012 to 79.23% in 2021, while the percentage of stroke death at hospitals decreased from 17.89% in 2012 to 15.89% in 2021.
The crude mortality of stroke surged, and intracerebral hemorrhage was the main death cause of all subtypes. The mortality of stroke in males and rural residents was higher than that in females and urban residents. Most stroke deaths occurred at home. Male and rural residents were crucial populations for stroke prevention and control. There should be improved medical resources in rural areas and enhanced capability of stroke diagnosis and treatment.
脑卒中已成为威胁全球人口健康的主要疾病之一,也是中国亟待解决的重大公共卫生问题。因此,分析脑卒中死亡率的趋势及其流行病学特征至关重要。
各医疗机构医务人员向全国死因登记系统报告脑卒中死亡病例,重庆市各区县统计局每年提供人口数据。根据 ICD-10 编码,计算死亡率、中国标准化人口标化死亡率(ASMRC)、年龄别死亡率、构成比和年度变化百分比(APC)。ASMRC 基于中国第六次人口普查 2010 年的标准人口。使用 χ2 检验比较各亚组的脑卒中死亡率。采用 APC 进行趋势分析。
重庆脑卒中的粗死亡率从 2012 年的 96.29/10 万显著上升至 2021 年的 115.93/10 万,APC 为 2.02%(t = 2.82,p = 0.022)。2012 年和 2021 年脑卒中的 ASMRC 分别为 56.47/10 万和 54.70/10 万,其变化趋势稳定(APC = -0.01,t = 0.07,p = 0.947)。男性脑卒中的粗死亡率每年均高于女性(p < 0.05)。2012 年至 2021 年,脑出血的死亡比例从 60.53%下降至 49.88%,而缺血性脑卒中的死亡比例从 20.92%上升至 39.96%。脑卒中死亡的平均年龄从 2012 年的 73.43 岁显著延迟至 2021 年的 76.52 岁(t = 18.12,p < 0.001)。2012 年至 2021 年,脑卒中死亡在家中的比例从 75.23%上升至 79.23%,而在医院的比例从 17.89%下降至 15.89%。
脑卒中的粗死亡率上升,脑出血是各亚型的主要死亡原因。男性和农村居民的脑卒中死亡率高于女性和城市居民。大多数脑卒中死亡发生在家中。男性和农村居民是脑卒中防治的重点人群。应改善农村地区的医疗资源,提高脑卒中的诊断和治疗能力。