Trend of Stroke Hospitalization, United States, 1988-1997 Editorial Comment (original) (raw)
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Trend of Stroke Hospitalization, United States, 1988 -1997
Background and Purpose-Age-adjusted stroke mortality in the United States has declined in recent decades. However, the course of stroke incidence is less certain. To address this issue, we determined trends of stroke hospitalization and in-hospital case fatality during 1988 -1997. Methods-Stroke hospitalization was estimated from National Hospital Discharge Survey as numerator and Current Population Survey as denominator. Hospitalization rates were determined and stratified by patient characteristics. Average length of hospital stay was also determined. In-hospital mortality was specified by sex, age, and other patient characteristics. The change in these rates over 10 years and average annual percent changes were calculated. Results-During 1988 -1997, age-adjusted stroke hospitalization rate increased 18.6% (from 560 to 664/100 000;
Trends in Acute Ischemic Stroke Hospitalizations in the United States
Journal of the American Heart Association, 2016
Population-based studies have revealed declining acute ischemic stroke (AIS) hospitalization rates in the United States, but no study has assessed recent temporal trends in race/ethnic-, age-, and sex-specific AIS hospitalization rates. Temporal trends in hospitalization for AIS from 2000 to 2010 were assessed among adults ≥25 years using the Nationwide Inpatient Sample. Age-, sex-, and race/ethnic-specific and age-adjusted stroke hospitalization rates were calculated using the weighted number of hospitalizations and US census data. From 2000 to 2010, age-adjusted stroke hospitalization rates decreased from 250 to 204 per 100 000 (overall rate reduction 18.4%). Age-specific AIS hospitalization rates decreased for individuals aged 65 to 84 years (846 to 605 per 100 000) and ≥85 years (2077 to 1618 per 100 000), but increased for individuals aged 25 to 44 years (16 to 23 per 100 000) and 45 to 64 years (149 to 156 per 100 000). Blacks had the highest age-adjusted yearly hospitalizatio...
Stroke, 2014
Background and Purpose-Stroke mortality has been declining since the early 20th century. The reasons for this are not completely understood, although the decline is welcome. As a result of recent striking and more accelerated decreases in stroke mortality, stroke has fallen from the third to the fourth leading cause of death in the United States. This has prompted a detailed assessment of the factors associated with the change in stroke risk and mortality. This statement considers the evidence for factors that have contributed to the decline and how they can be used in the design of future interventions for this major public health burden. Methods-Writing group members were nominated by the committee chair and co-chair on the basis of their previous work in relevant topic areas and were approved Results-The decline in stroke mortality over the past decades represents a major improvement in population health and is observed for both sexes and for all racial/ethnic and age groups. In addition to the overall impact on fewer lives lost to stroke, the major decline in stroke mortality seen among people <65 years of age represents a reduction in years of potential life lost. The decline in mortality results from reduced incidence of stroke and lower case-fatality rates. These significant improvements in stroke outcomes are concurrent with cardiovascular risk factor control interventions. Although
Declining Rate and Severity of Hospitalized Stroke From 2004 to 2013
Stroke, 2018
Background and Purpose— Stroke is a leading cause of morbidity and disability. We assessed trends in rates of hospitalized stroke and stroke severity on admission in a prospective national registry of stroke from 2004 to 2013. Methods— All 6693 acute ischemic strokes and intracerebral hemorrhage in the National Acute Stroke Israeli participants ≥20 years old were included. Data were prospectively collected in 2004 (February–March), 2007 (March–April), 2010 (April–May), and 2013 (March–April). Rates of hospitalized stroke from 2004 to 2013 were studied using generalized linear models assuming a quasi-Poisson error distribution with a log link. Stroke severity on admission was determined using the National Institutes of Health Stroke Scale score and trends were studied. Analysis was performed for stroke overall and by sex and age-group as well as by stroke type. Results— Estimated average annual rates of hospitalized stroke decreased from 24.9/10 000 in 2004 to 19.5/10 000 in 2013. Th...
Factors Influencing the Decline in Stroke Mortality
Stroke, 2013
Background and Purpose— Stroke mortality has been declining since the early 20th century. The reasons for this are not completely understood, although the decline is welcome. As a result of recent striking and more accelerated decreases in stroke mortality, stroke has fallen from the third to the fourth leading cause of death in the United States. This has prompted a detailed assessment of the factors associated with the change in stroke risk and mortality. This statement considers the evidence for factors that have contributed to the decline and how they can be used in the design of future interventions for this major public health burden. Methods— Writing group members were nominated by the committee chair and co-chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council’s Scientific Statements Oversight Committee and the American Heart Association Manuscript Oversight Committee. The writers used systematic ...
Journal of Stroke and Cerebrovascular Diseases, 1999
Objective: To identify changes in mortality and hospital use among patients admitted for ischemic stroke in Alabama. Background: The decline in stroke mortality in the Southeast is greater than in other US regions. Whether this decline is a result of decreased incidence or improved case-fatality rates is unknown. Methods: We examined Medicare hospitalization data from approximately 625,000 beneficiaries and identified patients admitted for ischemic stroke between January 1992 and December 1994. The search was carried out using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes pertinent to all diagnoses related to ischemic stroke. Data relevant to mortality and length of stay (LOS) were collected, and comparisons were made of the average case-fatality rate and LOS in each of the 3 years. Results: No significant difference was found in the incidence of ischemic stroke during the 3 years. The number of admissions was 4438 for 1992, 4124 for 1993, and 4762 for 1994. Conversely, the average LOS showed a significant decline, with values of 10.05, 9.36, and 8.72 days, respectively (P (.0003). A significant decline in mortality, with average case-fatality rates of 11.72%, 11.56%, and 9.71%, respectively (P (.003), was also found. Conclusion: These data suggest that the decline in stroke mortality in the Southeast is because of improved patient survival after stroke, rather than decreased incidence. Although several factors may be contributing to the decreased case-fatality rates, improved care of hospitalized stroke patients is likely of primary importance. Additionally, decreased mortality associated with decreased LOS suggests more efficient hospital use. Key Words; Stroke---Outcome--Incidence--Mortality.