Abstract
Background: Trends in the incidence of stroke are important for health care planning. Information
is particularly scarce in Australia, due to the paucity of studies with access to
recent, large-scale, longitudinal datasets. In this paper we investigated the incidence
of hospitalization for stroke by sex, age, and subtype in the whole State of Queensland
(Australia). Methods: We obtained data of all hospital admissions for stroke in Queensland from 2002 to
2015. Age standardized hospitalization rates for first-ever stroke were calculated
along with WHO adjusted rates. Poisson regression analyses were conducted to investigate
the influence of time and gender on the incidence of subtypes of stroke as well as
the total incidence. Results: Admissions for first-ever stroke were 57,597. Crude hospitalization incidence rose
from 87 (95% confidence interval [CI], 84-90) to 108 (95%CI, 105-111) for both sexes.
The highest increase was in the age bands 40-49 from 33 (95%CI, 26-40) to 54 (95%CI,
46-62; +62%) and 50-59 from 82 (95%CI, 70-93) to 127 (95%CI, 114-140; +56%) in men
and in 60-69 from 118 (95%CI, 100-136) to 159 (95%CI, 143-175; +34%) in women. Ischemic
subtype rates appeared to increase more than haemorrhagic rates. Age range, sex, and
year reliably predicted incidence rates. Conclusions: If these trends are maintained, the data predict further increases, especially in
males aged 40-59. With people apparently stroking earlier and mortality rates dropping,
the healthcare system in Australia is faced with a rapidly increasing care burden.
Key Words
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References
- Global stroke statistics.Int J Stroke. 2017; 12: 13-32
- Preventing stroke: saving lives around the world.Lancet Neurol. 2007; 6: 182-187
- Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association.Stroke. 2013; 44: 2361-2375
- Gender differences in stroke incidence and poststroke disability in the Framingham heart study.Stroke. 2009; 40: 1032-1037
- Selection of medical diagnostic codes for analysis of electronic patient records. Application to stroke in a primary care database.PLoS One. 2009; 4: e7168
Australian Consortium for Classification Development. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM/ACHI/ACS). Independent Hospital Pricing Authority; 2015.
- ICD-10-AM/ACHI/ACS Tenth Edition: development overview.HIM-Interchange. 2017; 7: 13-15
QHAPDC. Queensland Hospital Admission Data Collection. Manual of instructions and procedures for the completion of patient identification and diagnosis data. 2000. https://www.health.qld.gov.au/__data/assets/pdf_file/0032/662855/qhapdc-manual-1718-v1.0.pdf
- Validity of information on comorbidity derived from ICD-9-CCM administrative data.Med Care. 2002; 40: 675-685
- Differentiating incident from recurrent stroke using administrative data: the impact of varying lengths of look-back periods on the risk of misclassification.Neuroepidemiology. 2017; 48: 111-118
- A language and environment for statistical computing.R Foundation for statistical computing, Vienna2013
- Cancer incidence in five continents.Lyon (France): IARC. IARC Scientific Publications, 1976: 453-459
- Essential epidemiology: an introduction for students and health professionals:.Cambridge University Press, 2016
- Validation of intracranial hemorrhage in the Norwegian patient registry.Brain Behav. 2018; 8: e00900
- Validation of stroke diagnosis in the national registry of hospitalized patients in the Czech Republic.J Stroke Cerebrovasc Dis. 2015; 24: 2032-2038
- No evidence for an epidemic of stroke with the ageing of the population.Neuroepidemiology. 2012; 38: 268-273
- Disability burden due to stroke in Western Australia: new insights from linked data sources.Int J Stroke. 2010; 5: 269-277
- Stroke incidence and case-fatality among Indigenous and non-Indigenous populations in the Northern Territory of Australia, 1999-2011.Int J Stroke. 2015; 10: 716-722
- Stroke epidemiology in an Australian rural cohort (SEARCH).Int J Stroke. 2017; 12: 161-168
- Temporal trends in the incidence and recurrence of hospitalised atherothrombotic disease in an Australian population, 2000-07: data linkage study.Heart. 2012; 98: 1449-1456
- Stroke hospital admission rates in Brisbane and Queensland in 2015: data from 11,072 cases.Int J Stroke. 2019; 14: 417-421
- Stroke incidence on the east coast of Australia: the North East Melbourne Stroke Incidence Study (NEMESIS).Stroke. 2000; 31: 2087-2092
- Trends in incidence and outcome of stroke in Perth, Western Australia during 1989 to 2001: the Perth Community Stroke Study.Stroke. 2008; 39: 776-782
- Stroke incidence in Victoria, Australia—emerging improvements.Front Neurol. 2017; 8: 180
- Adelaide stroke incidence study: declining stroke rates but many preventable cardioembolic strokes.Stroke. 2013; 44: 1226-1231
- Cardiovascular disease snapshot.AIHW, Canberra2018
- Epidemiology of stroke in northern Italy: the cerebrovascular aosta registry, 2004–2008.Neurol Sci. 2013; 34: 1071-1081
Public Health England. “Briefing Document: First Incidence of Stroke–Estimates for England 2007 to 2016.” (2018). https://www.gov.uk/government/publications/first-stroke-estimates-in-england-2007-to-2016
- Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study.Circulation. 2005; 111: 1327-1331
- Long-term trends in incidence and risk factors for ischaemic stroke subtypes: Prospective population study of the South London Stroke Register.PLoS Med. 2018; 15e1002669
- Global stroke statistics.Int J Stroke. 2014; 9: 6-18
- Heart disease and stroke statistics-2016 update: a report from the American Heart Association.Circulation. 2016; 133: e38-360
- Sex differences in stroke incidence, prevalence, mortality and disability-adjusted life years: results from the global burden of disease study 2013.Neuroepidemiology. 2015; 45: 203-214
- Stroke incidence in young adults according to age, subtype, sex, and time trends.Neurology. 2019; 92: e2444-e2e54
- Ischemic stroke in the young: current perspectives on incidence, risk factors, and cardiovascular prognosis.Eur Stroke J. 2016; 1: 28-40
- Prevalence of cardiovascular risk factors and strokes in younger adults.JAMA Neurol. 2017; 74: 695-703
- Age at stroke: temporal trends in stroke incidence in a large, biracial population.Neurology. 2012; 79: 1781-1787
- Trends in the incidence of ischaemic stroke in young adults between 1985 and 2011: the Dijon Stroke Registry.J Neurol Neurosurg Psychiatry. 2013; (jnnp-2013-306203)
- Increasing stroke incidence in Sweden between 1989 and 2000 among persons aged 30 to 65 years: evidence from the Swedish Hospital Discharge Register.Stroke. 2004; 35: 1047-1051
- Increasing incidence of hospitalization for stroke and transient ischemic attack in young adults: a registry‐based study.J Am Heart Assoc. 2016; 5e003158
- Incidence, recurrence, and long-term survival of ischemic stroke subtypes: a population-based study in the Middle East.Int J Stroke. 2017; 12: 835-843
- Prevalence, incidence, and mortality of stroke in China clinical perspective: results from a nationwide population-based survey of 480 687 adults.Circulation. 2017; 135: 759-771
- Time trends in stroke incidence and in prevalence of risk factors in Southern Germany, 1989 to 2008/09.Scient Rep. 2018; 8: 11981
- Trends in acute ischemic stroke hospitalizations in the United States.J Am Heart Assoc. 2016; 5e003233
- Temporal trends in ischemic stroke incidence in younger adults in the framingham study.Stroke. 2019; 50: 1558-1560
- Temporal trends in sex differences with regard to stroke incidence: the Dijon stroke registry (1987–2012).Stroke. 2017; 48: 846-849
- Temporal trends of sex differences in transient ischemic attack incidence within a population.J Stroke Cerebrovasc Dis. 2019; 28: 2468-2474
- Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study.Neurology. 2017; 89: 990-996
- A working paper using linked hospitali-sation and deaths data from Western Australia and New South Wales.CVD 68 Canberra, 2014
- Moderate agreement between self-reported stroke and hospital-recorded stroke in two cohorts of Australian women: a validation study.BMC Med Res Methodol. 2015; 15: 7
- Identification of diabetes, heart disease, hypertension and stroke in mid- and older-aged women: comparing self-report and administrative hospital data records.Geriatr Gerontol Int. 2016; 16: 95-102
- Comparable studies of the incidence of stroke and its pathological types.Stroke. 1997; 28: 491-499
- Coding and DRG relationships in stroke and transient ischaemic attack (TIA).Him J. 2006; 35: 38-44
- National stroke registries for monitoring and improving the quality of hospital care: a systematic review.Int J Stroke. 2016; 11: 28-40
- Quality and complexity measures for data linkage and deduplication.Quality measures in data mining. Springer, 2007: 127-151
- Headache in United States emergency departments: demographics, work‐up and frequency of pathological diagnoses.Cephalalgia. 2006; 26: 684-690
- Are more young people having strokes?—a simple question with an uncertain answer.JAMA Neurol. 2017; 74: 639-641
- Can a media campaign change health service use in a population with stroke symptoms? Examination of the first Irish stroke awareness campaign.Emerg Med J. 2014; 31: 536-540
- Stroke public awareness campaigns have increased ambulance dispatches for stroke in Melbourne.Australia. Stroke. 2011; 42: 2154-2157
- Risk factors in young stroke.J Med. 2020; 21: 26-30
- Strokes in young adults: epidemiology and prevention.Vasc health Risk Manag. 2015; 11: 157
Article info
Publication history
Published online: April 09, 2020
Accepted:
February 26,
2020
Received in revised form:
February 3,
2020
Received:
August 17,
2019
Footnotes
Funding: None to declare.
Conflicts of Interest: None to declare.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104797
Copyright
© 2020 Elsevier Inc. All rights reserved.
