Rangamani Sukanya, Huliyappa Deepadarshan, Kulothungan Vaitheeswaran, Saravanan Sankaralingam, Murugan P K, Mahadevan Radha, Rachel Packiaseeli Chelladurai, Bobby Esakki, Sunitha Kandasamy, Mallick Ashok Kumar, Nayak Soumya Darshan, Swain Santosh Kumar, Behera Manoranjan, Nath Bhaskar Kanti, Swami Abhijit, Kalwar Amit Kumar, Difoesa Bijush, Sardana Vijay, Maheshwari Dilip, Bhushan Bharat, Mittal Deepika, Chaurasia Rameshwar Nath, Meena L P, Vinay Urs K S, Koli Rahul Rajendra, Suresh Kumar Natesan, Mathur Prashant
ICMR-National Centre for Disease Informatics and Research, II Floor of Nirmal Bhawan, ICMR Complex Kannamangala Post, Bengaluru, 562 110, India.
Tirunelveli Medical College, Tirunelveli, 627011, India.
Lancet Reg Health Southeast Asia. 2023 Oct 28;23:100308. doi: 10.1016/j.lansea.2023.100308. eCollection 2024 Apr.
Increasing stroke burden in India demands a long-term stroke surveillance framework. Earlier studies in India were urban-based, short term and provided limited data on stroke incidence and its outcomes. This gap is addressed by the establishment of five population-based stroke registries (PBSRs) of the National Stroke Registry Programme, India. This paper describes stroke incidence, mortality and age, sex, and subtypes distribution in the five PBSRs with urban and rural populations.
First-ever incident stroke patients in age group ≥18 years, resident for at least one year in the defined geographic area, identified from health facilities were registered. Death records with stroke as the cause of death from the Civil Registration System (CRS) were included. Transient ischemic attack (TIA) was excluded. Three PBSRs (Cuttack, Tirunelveli, Cachar) included urban and rural populations. PBSRs in Kota and Varanasi were urban areas. The crude and age-standardized incidence rate (ASR) by age, sex, and residence (urban and rural), rate ratios of ASR, case fatality proportions and rates at day 28 after onset of stroke were calculated for years 2018-2019.
A total of 13,820 registered first-ever stroke cases that included 985 death certificate-only cases (DCOs) were analysed. The pooled crude incidence rate was 138.1 per 100,000 population with an age-standardized incidence rate (ASR) of 103.4 (both sexes), 125.7 (males) and 80.8 (females). The risk of stroke among rural residents was one in seven (Cuttack), one in nine (Tirunelveli), and one in 15 (Cachar). Ischemic stroke was the most common type in all PBSRs. Age-standardized case fatality rates (ASCFR) per 100,000 population for pooled PBSRs was 30.0 (males) and 18.8 (females), and the rate ratio (M/F) ranged from 1.2 (Cuttack) to 2.0 (Cachar).
Population-based registries have provided a comprehensive stroke surveillance platform to measure stroke burden and outcomes by age, sex, residence and subtype across India. The rural-urban pattern of stroke incidence and mortality shall guide health policy and programme planning to strengthen stroke prevention and treatment measures in India.
The National Stroke Registry Programme is funded through the intramural funding of the Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, India.
印度中风负担日益加重，需要一个长期的中风监测框架。印度早期的研究以城市为基础，为期较短，且关于中风发病率及其结果的数据有限。印度国家中风登记计划建立的五个基于人群的中风登记处（PBSR）填补了这一空白。本文描述了五个包含城市和农村人口的PBSR中的中风发病率、死亡率以及年龄、性别和亚型分布。
登记从医疗机构中识别出的年龄≥18岁、在规定地理区域居住至少一年的首次发生中风的患者。纳入民事登记系统（CRS）中以中风为死因的死亡记录。排除短暂性脑缺血发作（TIA）。三个PBSR（科塔克、蒂鲁内尔维利、卡恰尔）涵盖城市和农村人口。科塔和瓦拉纳西的PBSR为城市地区。计算了2018 - 2019年按年龄、性别和居住地（城市和农村）划分的粗发病率和年龄标准化发病率（ASR）、ASR的率比、中风发病后第28天的病死率比例和率。
共分析了13820例登记的首次中风病例，其中包括985例仅死亡证明病例（DCO）。汇总的粗发病率为每10万人口138.1例，年龄标准化发病率（ASR）为103.4（男女合计）、125.7（男性）和80.8（女性）。农村居民中风风险在科塔克为七分之一，在蒂鲁内尔维利为九分之一，在卡恰尔为十五分之一。缺血性中风是所有PBSR中最常见的类型。汇总的PBSR每10万人口的年龄标准化病死率（ASCFR）男性为30.0，女性为18.8，率比（男/女）范围从1.2（科塔克）到2.0（卡恰尔）。
基于人群的登记处提供了一个全面的中风监测平台，以衡量印度各地按年龄、性别、居住地和亚型划分的中风负担和结果。中风发病率和死亡率的城乡模式将指导卫生政策和项目规划，以加强印度的中风预防和治疗措施。
国家中风登记计划由印度卫生与家庭福利部卫生研究司印度医学研究理事会的内部资金资助。
