Gillum R F, Gomez-Marin O, Kottke T E, Jacobs D R, Prineas R J, Folsom A R, Luepker R V, Blackburn H
J Chronic Dis. 1985;38(11):891-8. doi: 10.1016/0021-9681(85)90124-9.
Mortality rates for stroke, and hospitalization and case fatality rates for acute stroke in 1970 and 1980 were obtained for residents aged 30-74 of the Twin Cities (Minneapolis--St Paul) metropolitan area to determine whether improved hospital care contributed to the decline in stroke mortality. Age-adjusted mortality rates per 100,000 declined significantly in that decade for men (1970, 89.4; 1980, 47.5; p less than 0.01) and women (1970, 72.6; 1980, 40.9; p less than 0.01). Age-adjusted hospitalization rates per 100,000 population also declined significantly for men (1970, 438; 1980, 323; p less than 0.01) and women (1970, 331; 1980, 203; p less than 0.01). Age-adjusted mean length of hospital stay did not change significantly. Hospital case fatality declined for men aged 30-64 years (1970, 22.5%; 1980, 15.1%; p less than 0.01) but did not change significantly for 65 to 74 year-old men (1970, 16.5%; 1980, 20.0%; p = 0.09) or for all women (age-adjusted rates: 1970, 13.6%; 1980, 16.0%; p = 0.17). There was no change in the distribution of severity of hospitalized cases between years. Therefore, the decline in stroke mortality is consistent with a decreased incidence of stroke resulting from improved hypertension control. Improvements in hospital medical care appear not to have contributed substantially to the decline in stroke mortality.
获取了明尼阿波利斯 - 圣保罗双城都市区30 - 74岁居民1970年和1980年的中风死亡率、急性中风的住院率和病死率，以确定医院护理的改善是否有助于中风死亡率的下降。在那十年中，每10万人的年龄调整死亡率男性显著下降（1970年为89.4；1980年为47.5；p<0.01），女性也显著下降（1970年为72.6；1980年为40.9；p<0.01）。每10万人口的年龄调整住院率男性（1970年为438；1980年为323；p<0.01）和女性（1970年为331；1980年为203；p<0.01）同样显著下降。年龄调整后的平均住院时间没有显著变化。30 - 64岁男性的医院病死率下降（1970年为22.5%；1980年为15.1%；p<0.01），但65至74岁男性（1970年为16.5%；1980年为20.0%；p = 0.09）或所有女性（年龄调整率：1970年为13.6%；1980年为16.0%；p = 0.17）的病死率没有显著变化。不同年份住院病例的严重程度分布没有变化。因此，中风死亡率的下降与高血压控制改善导致的中风发病率降低相一致。医院医疗护理的改善似乎对中风死亡率的下降没有实质性贡献。
