Kilkenny Monique, Burns Catherine, Sanders Ailie, Sanders Lauren M, Dalli Lachlan L, Feigin Valery, Cadilhac Dominique A, Donnan Geoffrey, Norrving Bo, Olaiya Muideen T, Nair Balakrishnan, Henry Nathan, Kilkenny Monique F
Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Department of Neurosciences, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Neuroepidemiology. 2025;59(5):593-601. doi: 10.1159/000542301. Epub 2024 Oct 28.
Cerebrovascular accident (CVA) is an outdated term for describing stroke as it implies stroke is an accident. We conducted an integrative review to examine the use of CVA in terms of (1) frequency in major medical journals over time; (2) associated publication characteristics (e.g., number of authors, senior author country, topic); and (3) frequency in medical records.
We searched Google Scholar for publications in leading neurology and vascular journals (Quartile 1) across two 5-year periods (1998-2002 and 2018-2022) using the terms "cerebrovascular accident" or "CVA." Two reviewers independently reviewed full-text publications and recorded the frequency of CVA use. Rates of use (per 1,000 articles/year) were calculated for each journal and time period. Associations of publication characteristics with CVA use were determined using multivariable logistic regression models. In addition, admission and discharge forms in the Auckland Regional Community Stroke Study (ARCOS V) were audited for frequency of use of the term CVA.
Of the 1,643 publications retrieved, 1,539 were reviewed in full. Of these, CVA was used ≥1 time in 676 publications, and ≥2 times in 276 publications (129 in 1998-2002; 147 in 2018-2022). The terms CVA and stroke both appeared in 57% of publications where CVA was used ≥2 times in 1998-2002, compared to 65% in 2018-2022. Majority of publications were on the topic of stroke (22% in 1998-2002; 20% in 2018-2022). There were no associations between publication characteristics and the use of CVA. The highest rate of CVA use in 2018-2022 was in Circulation, which had increased over time from 1.3 uses per 1,000 publications in 1998-2002 to 1.8 uses per 1,000 publications in 2018-2022. The largest reduction in the use of CVA was in Neuroepidemiology (2.0 uses per 1,000 publications in 1998-2002 to 0 uses in 2018-2022). The term CVA was identified in 0.2% (17/7,808) of stroke admission and discharge forms audited.
We found evidence of changes in the use of CVA in the scientific literature over the past two decades. Editors, authors, and clinicians should avoid the use of the term CVA as it perpetuates the use of an ambiguous and inappropriate term.
脑血管意外（CVA）是描述中风的一个过时术语，因为它暗示中风是一种意外情况。我们进行了一项综合综述，以研究CVA的使用情况，包括：（1）随着时间推移在主要医学期刊中的出现频率；（2）相关的出版特征（如作者数量、资深作者所在国家、主题）；以及（3）在医疗记录中的出现频率。
我们在谷歌学术上搜索了两个5年时间段（1998 - 2002年和2018 - 2022年）内领先的神经病学和血管期刊（第一四分位数）中使用“脑血管意外”或“CVA”的出版物。两名评审员独立评审全文出版物并记录CVA的使用频率。计算每个期刊和时间段的使用率（每年每1000篇文章）。使用多变量逻辑回归模型确定出版特征与CVA使用之间的关联。此外，对奥克兰地区社区中风研究（ARCOS V）的入院和出院表格进行审核，以查看CVA一词的使用频率。
在检索到的1643篇出版物中，1539篇进行了全文评审。其中，676篇出版物中至少使用了1次CVA，276篇出版物中至少使用了2次CVA（1998 - 2002年为129篇；2018 - 2022年为147篇）。在1998 - 2002年CVA至少使用2次的出版物中，CVA和中风这两个术语都出现的占57%，而在2018 - 2022年为65%。大多数出版物的主题是中风（1998 - 2002年为22%；2018 - 2022年为20%）。出版特征与CVA的使用之间没有关联。2018 - 2022年CVA使用率最高的是《循环》杂志，其使用率从1998 - 2002年每1000篇出版物1.3次增加到2018 - 2022年每1000篇出版物1.8次。CVA使用减少最多的是《神经流行病学》（从1998 - 2002年每1000篇出版物2.0次降至2018 - 2022年的0次）。在审核的中风入院和出院表格中，CVA一词出现在0.2%（17/7808）中。
我们发现有证据表明在过去二十年中科学文献中CVA的使用发生了变化。编辑、作者和临床医生应避免使用CVA一词，因为它使一个模糊且不恰当的术语持续使用。
