Neurology: A study of 200,000 people in Canada: In the past 15 years, the incidence and mortality of stroke have dropped significantly

Stroke is the fifth leading cause of death in the United States and the leading cause of disability worldwide.
Numerous studies have found that in the past 30 years, the global stroke mortality rate has declined.
Although stroke mortality in the population can be attributed to a decrease in stroke incidence or a decrease in stroke case mortality, there is a large amount of evidence that the case mortality rate after acute ischemic stroke is decreasing.

Stroke

However, there are still uncertainties in the temporal trend of case fatality in stroke.
First, the change in case mortality after intracerebral hemorrhage is not as consistent as the change in case mortality after ischemic stroke.
Either a decrease or no change can be observed.
Studies usually include one type of stroke or a combination of the two, and only a few studies stratify by stroke type in the same population.
Second, the use of time changes in intensive care, such as intensive care admissions or life-sustaining procedures, may affect case mortality, but it is usually not considered in trend studies.
Third, active care that focuses on reducing mortality in early cases after stroke may create a trade-off that delays death at the expense of severe disability and the need for long-term care in nursing homes or comprehensive care facilities.
In this way, Raed A.

Joundi and others of the University of Calgary in Canada used a large, population-based cohort to explore the case fatality rate, discharge destination and long-term admission after acute ischemic stroke and intracerebral hemorrhage (ICH).
The long-term 15-year trend of nursing,

They used the data of all emergency department visits and first ischemic stroke or ICH admissions in Ontario, Canada from 2003 to 2017, and calculated the rough and age/sex-standardized mortality risk of 30 days and 1 year from the onset of stroke.

The rough trend was stratified according to stroke type, age and gender, and the Kendall τ-b correlation coefficient was used to assess the importance of the trend.
Finally, the trend of returning home from the hospital, recovering and entering long-term care after 1 year was determined.

A total of 163,574 patients with acute ischemic stroke or ICH were found.
From 2003 to 2017, the age/sex standard 30-day stroke case mortality rate dropped from 20.
5% to 13.
2% ( absolute value decreased by 7.
3%, relative value decreased by 36%), and the 1-year mortality rate decreased from 32.
2% 22.
8% (absolute value decreased by 9.
3%, relative value decreased by 29%).

The age/sex-standardized 30-day stroke case mortality rate decreased from 20.
5% to 13.
2% (the age/sex-standardized 30-day stroke case mortality rate decreased from 20.
5% to 13.
2% (

After adjusting for comorbidities, stroke severity, and the use of life-sustaining care, the results of the studies for different ages, genders, and stroke types are consistent.

After adjusting for comorbidities, severity of stroke, and use of life-sustaining care, the results of studies of different ages, genders, and stroke types were consistent.
After adjusting for comorbidities, severity of stroke, and use of life-sustaining care, the results of studies of different ages, genders, and stroke types were consistent.

The number of long-term care admissions after ischemic stroke has decreased, and the number of people discharged home or recovered from the two types of strokes has increased.

The significance of this study lies in the discovery that the incidence of acute stroke has dropped significantly during the period 2003-2017, and the mortality rate of acute stroke cases has dropped significantly.
At the same time, the number of people discharged home or recovered and the number of long-term care hospitalizations has decreased, which shows that The stroke care system continues to improve.

Original Source: neurology.

org/content/early/2021/03/23/WNL.
0000000000011791" target="_blank" rel="noopener">Temporal Trends in Case Fatality, Discharge Destination, and Admission to Long-term Care After Acute Stroke

neurology.
org/content/early/2021/03/23/WNL.
0000000000011791" target="_blank" rel="noopener">Temporal Trends in Case Fatality, Discharge Destination, and Admission to Long-term Care After Acute Stroke
neurology.
org/content/early/2021/03/23/WNL.
0000000000011791" target="_blank" rel="noopener">Raed A.
Joundi, Eric E.
Smith, Amy YX Yu, Mohammed Rashid, Jiming Fang, Moira K.
Kapral
neurology.
org/content/early/2021/03/23/WNL.
0000000000011791" target="_blank" rel="noopener">Neurology Mar 2021, 10.
1212/WNL .
0000000000011791; DOI: 10.
1212/WNL.
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