JAMA Sub-Journal: Changes in the severity and outcome of ischemic and hemorrhagic strokes in the past 20 years

Over the past half-century, brain stroke morbidity and mortality after age-adjusted decline sharply, but the trend has slowed in recent decades
.

Over the past half-century, brain stroke morbidity and mortality after age-adjusted decline sharply, but the trend has slowed in recent decades
.
Over the past half-century, brain stroke morbidity and mortality after age-adjusted decline sharply, but the trend has slowed in recent decades

.

Statistics Vascular JAMA

This nationwide, hospital-based, multicenter, prospective registered cohort study used the Japanese Stroke Database and included patients with acute strokes from January 2000 to December 2019
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We studied stroke patients registered within 7 days of the onset of symptoms, including ischemic and hemorrhagic strokes

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The main result was the initial severity of ischemic stroke and intracerebral hemorrhage, which was assessed by the NIHSS scale, and the initial severity of subarachnoid hemorrhage was graded and assessed by the World Federation of Neurosurgeons (WFNS)
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If the mRS score is 0-2 points, the judgment result is good; if it is 5-6 points, the judgment result is not good

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Among the 183080 patients, 135266 (53800 women [39.
8%]; median [IQR] age, 74[66-82] years) developed ischemic stroke, and 36014 (15365 women [42.
7%]; Median [IQR] age, 70[59-79] years) developed intracerebral hemorrhage, 11800 (7924 women [67.
2%]; median [IQR] age, 64[53-75] years) developed arachnoid Bleeding from the lower cavity
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In all three stroke types, the median age at onset increased, and the NIHSS scale and WFNS scores decreased in the multivariate analysis over the entire 20 years

.

In all three stroke types, the median age at onset increased, and the NIHSS scale and WFNS scores decreased in the multivariate analysis over the entire 20 years

In ischemic stroke, the proportion of favorable outcomes gradually increases over time (Female OR=1.

MRS score by gender at discharge

In general, unfavorable outcomes and hospital deaths have decreased among men and women
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In intracerebral hemorrhage, both men and women have beneficial results, and unfavorable results and deaths are only reduced in women

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Unfavorable results and hospital deaths have decreased among men and women

In summary, in the past 20 years, the functional prognosis of patients with ischemic stroke has improved, which may be partly due to the development of acute reperfusion therapy

references:

Twenty-Year Change in Severity and Outcome of Ischemic and Hemorrhagic Strokes.

JAMA Neurol.

Twenty-Year Change in Severity and Outcome of Ischemic and Hemorrhagic Strokes.
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