Abstract T MP63: Temporal Trends in Stroke Incidence Over the Past Twenty Years: Stroke Incidence Has Stabilized, Racial Disparity is not Improving

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Dawn Kleindorfer ◽  
Kathleen Alwell ◽  
Jane Khoury ◽  
Charles J Moomaw ◽  
Daniel Woo ◽  
...  
Keyword(s):  
Racial Disparities ◽  
Racial Disparity ◽  
Temporal Trends ◽  
Census Bureau ◽  
Incidence Rates ◽  
Ohio River ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Physician Review ◽  
Health Significance

Introduction: We previously reported that the incidence of stroke was decreasing for whites but stable for blacks from 1993/94 to 2005. We sought to describe recent temporal trends and racial disparities in stroke incidence within our large, bi-racial population, by including a more recent study period. Methods: The Greater Cincinnati/Northern Kentucky region includes two southern Ohio and three Northern Kentucky counties on the Ohio River, a population of 1.3 million. Our study ascertained all hospitalized strokes that occurred in the population between 7/1/93 and 6/30/94 and in calendar years 1999, 2005, and 2010. For 2010, nursing review of medical records is complete but physician review is not; thus, rates for 2010 (calculated using a weighted estimation for events not completely reviewed) are preliminary. The denominator for the calculation of incidence rates (in those aged >20 years) was estimated from the U.S. Census Bureau website (www.census.gov). The 95% confidence intervals (CI) for the incidence rates were calculated assuming a Poisson distribution. Rates are age, gender, and race adjusted, as appropriate, and standardized to the 2000 U.S. population. Results: Stroke incidence rates stratified by subtype, race, and study period are presented in the Table. We project that stroke incidence did not significantly change in 2010 vs. 2005 for either blacks or whites, regardless of stroke subtype. Blacks have a substantially higher incidence of stroke compared with whites in all study periods. Discussion: In contrast to the trend seen from 1993-94 to 2005, there was no further decline of stroke incidence in whites in 2010, a disappointing finding of great public health significance. Stroke incidence in blacks remains unchanged over all periods. The substantial black > white racial disparity in stroke incidence has not changed over time. Further study is needed to understand and eventually reduce these racial disparities.

Abstract TMP58: Preliminary Population-Based Temporal Trends in Stroke Incidence: Racial Disparity and Stroke Incidence From 1993-2015

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Dawn O Kleindorfer ◽  
Kathleen Alwell ◽  
Jane Khoury ◽  
Charles Moomaw ◽  
Daniel Woo ◽  
...  
Keyword(s):  
Racial Disparity ◽  
Temporal Trends ◽  
Population Based ◽  
Stroke Incidence

Abstract T P135: Geographic Microtargeting: Identifying High Risk Stroke Populations

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jason Mackey ◽  
Heidi Sucharew ◽  
Monir Hossain ◽  
David E Jones ◽  
Kathleen Alwell ◽  
...  
Keyword(s):  
High Risk ◽  
Recurrent Events ◽  
Census Data ◽  
Incidence Rates ◽  
High Yield ◽  
Stroke Incidence ◽  
Census Tracts ◽  
Physician Review ◽  
Institutionalized Patients ◽  
The Impact

Introduction: Though the incidence of acute ischemic stroke is decreasing overall in the US, improvement is not occurring uniformly. A high-yield strategy might be to identify and target micropopulations of very high-risk patients. Methods: All acute ischemic strokes among residents in the Greater Cincinnati/Northern Kentucky (GCNK) region (estimated population: 1.3 million) at least 20 years of age were identified using ICD-9 codes of 430-436 and verified by physician review in the calendar years 1999 and 2005. Each patient residing at home was geocoded according to listed home address; institutionalized patients were excluded. We calculated crude incidence rates for the 346 census tracts and used stroke events for numerators and 2000 Census data for denominators. We produced incidence maps for 1999 and 2005 and a rate change map for comparison. Results: We identified 2330 acute ischemic strokes in the GCNK region in 1999 and 2165 in 2005. After excluding recurrent events, events in institutionalized patients, and events in patients without geocodable addresses, we identified 1942 patients in 1999 and 1766 patients in 2005 for this analysis. Overall incidence was 189/100,000 in 1999 and 167/100,000 in 2005. The interquartile range of incidences in the census tracts was 124 - 270/100,000 in 1999 and 112 - 243/100,000 in 2005. Rates by year and rate difference are shown in the Figure. There were 23 census tracts with rates >300/100,000 in both study years and 21 census tracts with a rate increase >200/100,000 from 1999 to 2005. Discussion: Stroke incidence varies widely in census tracts in the GCNK region. We identified several micropopulations in which targeted efforts might result in reductions of stroke burden on the population. Further investigation of the impact of socioeconomic status and risk factors in these micropopulations will help tailor stroke reduction efforts. Microtargeting deserves further study in stroke education and prevention endeavors.

Temporal trends in stroke incidence and case-fatality rates in Arcadia, Greece: A sequential, prospective, population-based study

2021 ◽  
pp. 174749302199559
Author(s):  
Eleni Karantali ◽  
Konstantinos Vemmos ◽  
Evangelos Tsampalas ◽  
Konstantinos Xynos ◽  
Persefoni Karachalia ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Temporal Trends ◽  
Case Fatality ◽  
Population Based ◽  
Incidence Rates ◽  
European Population ◽  
Fatality Rate ◽  
Population Based Study ◽  
Stroke Incidence ◽  
Southern Greece

Background Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. Aims The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. Methods All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015–2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. Results In total, 1315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100,000 person-years (95% CI 231–239) in 1993/1995, 252 (95% CI 223–286) in 2004, and 211 (192–232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95% CI: 0.72–0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio = 0.72, 95% CI: 0.58–0.90). Conclusions This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.

Abstract 72: Temporal Trends in Stroke Incidence Over Time by Sex and Age in the Greater Cincinnati Northern Kentucky Stroke Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Tracy E Madsen ◽  
Jane C Khoury ◽  
Michelle Leppert ◽  
Kathleen Alwell ◽  
Charles J Moomaw ◽  
...  
Keyword(s):  
Older Adults ◽  
Temporal Trends ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Bonferroni Correction ◽  
Stroke Incidence ◽  
Stroke Study ◽  
Trends Over Time ◽  
Over Time

Introduction: Data from the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) through 2010 showed that over time, stroke incidence rates decreased to a greater extent in men than in women. We aimed to determine whether this difference continued through 2015 and whether the differences are driven by particular age groups. Methods: Within the GCNKSS population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at all local hospitals during 7/93–6/94 and calendar years 1999, 2005, 2010, and 2015. Out-of-hospital cases were sampled. Sex-specific incidence rates per 100,000 were adjusted for age and race, standardized to the 2010 U.S. Census. Trends over time by sex were compared (overall and age-stratified); a Bonferroni correction was applied for multiple comparisons. Results: In total over the five study periods, there were 9721 incident strokes (ischemic, ICH, and SAH); 56.4% were women. Incidence of ischemic strokes decreased from 254 (95%CI 236,272) in 1993/4 to 177 (95%CI 164,189) in 2015 among men (p<.0001 for trend over time) and from 204 (95%CI 192,217) in 1993/4 to 151 (95%CI 141,161) in 2015 among women (p<.0001). Incidence of ICH/ SAH did not change significantly over time in either sex. In age-stratified analyses, among women, incidence of all strokes decreased among older adults (65–84 years) but not in other age categories (Figure). Among men, incidence over time decreased among older adults (65–84 and ≥ 85 years) but increased in young adults (20–44 years). Conclusions: Stroke incidence decreased between the early 1990s and 2015 for both sexes, contrary to previous data on trends through 2010 which demonstrated a significant decrease in men but not women. Temporal changes are being driven by the 65–84 year age group in both men and women, as well as the ≥ 85 age group in men. Future prevention strategies should target young and middle age adults for both sexes as well as those over 85 for women.

Abstract 139: Trends in Ischemic Stroke Subtype Over a 17-Year Period

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Stacie L Demel ◽  
Jane C Khoury ◽  
Charles J Moomaw ◽  
Kathleen Alwell ◽  
Brett M Kissela ◽  
...  
Keyword(s):  
Population Based ◽  
Incidence Rates ◽  
Large Vessel ◽  
Cardiac Monitoring ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Stroke Subtypes ◽  
Ischemic Stroke Subtype ◽  
Age Adjusted Rates ◽  
Over Time

Introduction: Overall US stroke incidence rates have declined. Prior analysis of the Cincinnati region has demonstrated more thorough diagnostic workups coinciding with decreased proportion of cryptogenic and increased proportion of cardioembolic strokes over time in those patients presenting to the ED. We now examine trends in population-based incidence rates of stroke subtypes. Methods: Within the Greater Cincinnati/Northern Kentucky catchment area of 1.3 million, all strokes were ascertained between July 1993 and June 1994 and in 1999, 2005 and 2010. Incidence rates per 100,000, age-, race- and sex-adjusted to the 2000 US population, and associated 95% confidence intervals were calculated. Changes in stroke-subtype proportions over time were examined using a general linear model. Results: There were a total of 6859 incident ischemic strokes (1709 in 1993/94, 1778 in 1999, 1681 in 2005, and 1691 in 2010; age ≥20 years), of which 1290 (18.8%) were black and 3846 (56.1%) female. The Table shows subtype-adjusted incident rates by study period. Incidence rates of both small- and large-vessel etiology showed no significant change over time. Incidence rates of both cardioembolic and other known etiology increased significantly over time, whereas incidence rates of unknown subtype decreased significantly. Conclusions: In our large, biracial population-based cohort, while overall stroke incidence rates have been stable or declining over the last 17 years, trends for individual stroke subtypes have varied. Consistent with our prior analyses, more strokes have been attributed to cardioembolic etiology, whereas strokes attributable to small-vessel and large-vessel etiology have remained stable. The increase in cardioembolic strokes may be due to age and/or prolonged cardiac monitoring. Future analysis of age-adjusted rates for atrial fibrillation over time is warranted.

Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry

2021 ◽  
pp. 1-6
Author(s):  
Yannick Béjot ◽  
Gauthier Duloquin ◽  
Quentin Thomas ◽  
Sophie Mohr ◽  
Lucie Garnier ◽  
...  
Keyword(s):  
Young Adults ◽  
Sex Differences ◽  
Ischemic Stroke ◽  
Temporal Trends ◽  
Population Based ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Stroke In Young Adults ◽  
Stroke In Young

<b><i>Introduction:</i></b> Stroke is associated with major consequences in terms of socioeconomic impact and lost disability-adjusted life in young victims, thus justifying a careful surveillance of epidemiological trends. This study aimed to assess changes in the incidence of ischemic stroke in young adults over a long period. <b><i>Methods:</i></b> All cases of first-ever ischemic stroke that occurred among adults aged 18–55 years were prospectively recorded using the population-based Dijon Stroke Registry, from 1985 to 2017. Sex-specific annual incidence rates were calculated and were presented according to 6 time periods. Incidence rate ratios (IRRs) were determined to assess sex differences in stroke incidence. <b><i>Results:</i></b> Over the whole study period, 4,451 patients suffered a first-ever ischemic stroke. Among these patients, 469 (10.5%) were young adults (median age: 46 years, IQR: 39–50; 53.9% men). Incidence rates rose from the study period 2003 to 2007 compared with previous periods and remained stable thereafter, both in men and women. Hence, incidence per 100,000 per year was globally 11.0 (95% CI: 9.4–12.7) before 2003 and 22.9 (20.3–25.6) thereafter. In individuals aged 18–45 years, incidence rates were 5.4 (4.3–6.9) overall, 4.1 (2.7–6.0) in men, and 6.7 (4.9–9.0) in women, before 2003. After 2003, incidence rates rose to 12.8 (10.7–15.1) overall, 12.0 (9.2–15.4) in men, and 13.6 (10.6–17.0) in women. In this age group, the men/women IRR was 0.78 (95% CI: 0.62–1.26, <i>p</i> = 0.08), although sex differences decreased over time (IRR = 0.62; 95% CI: 0.36–1.02, <i>p</i> = 0.046 before 2003, vs. IRR = 0.88; 95% CI: 0.62–1.26, <i>p</i> = 0.48 after 2003). In individuals aged 45–55 years, incidence rates before 2003 were 47 (37–61) in men and 25 (17–35) in women (IRR = 1.90; 95% CI: 1.24–2.97, <i>p</i> &#x3c; 0.001), and they increased to 82 (67–100) in men and 46 (35–59) in women (IRR = 1.79; 95% CI: 1.29–2.49, <i>p</i> &#x3c; 0.001) after 2003. <b><i>Conclusions:</i></b> The incidence of ischemic stroke in young adults increased during the early 2000s and remained stable thereafter. These results highlight the priority need for dedicated prevention strategies for the young to reduce the burden of stroke.

scholarly journals Temporal Trends in Stroke-Related Memory Change

Stroke ◽  
2021 ◽  
Author(s):  
Chloe W. Eng ◽  
Elizabeth R. Mayeda ◽  
Paola Gilsanz ◽  
Rachel A. Whitmer ◽  
Anthony S. Kim ◽  
...  
Keyword(s):  
Linear Trend ◽  
Temporal Trends ◽  
Stroke Care ◽  
Incidence Rates ◽  
Stroke Onset ◽  
Linear Regression Models ◽  
Stroke Incidence ◽  
Memory Change ◽  
Incidence And Mortality ◽  
Nationally Representative

Background and Purpose: Findings from the Framingham Heart Study suggest that declines in dementia incidence rates over recent decades are partially due to decreases in stroke incidence and mortality; however, whether trends of declining dementia rates extend to survivors of incident stroke remains unclear. We investigated evidence for temporal trends in memory change related to incident stroke in a nationally representative cohort. Methods: Adults age 50+ in the HRS (Health and Retirement Study) were followed across three successive 6-year epochs (epoch 1: 1998–2004, n=16 781; epoch 2: 2004–2010, n=15 345; and epoch 3: 2010–2016; n=15 949). Participants were included in an epoch if they were stroke-free at the start of that epoch. Annual rates of change in a composite z-standardized memory score were compared using demographic-adjusted linear regression models for stroke-free participants, those who survived after stroke, and those who died after stroke, considering memory change before stroke, at the time of stroke, and for years following stroke. Results: Crude stroke incidence rates decreased from 8.5 per 1000 person-years in epoch 1 to 6.8 per 1000 person-years in epoch 3. Rates of memory change before and following stroke onset were similar across epochs. Memory decrement immediately after stroke onset attenuated from −0.37 points (95% CI, −0.44 to −0.29) in epoch 1 to −0.26 (95% CI, −0.33 to −0.18) points in epoch 2 and −0.25 (95% CI, −0.33 to −0.17) points in epoch 3 ( P value for linear trend=0.02). Conclusions: Decreases in stroke-related dementia in recent years may be partially attributable to smaller memory decrements immediately after stroke onset. Findings suggest reductions in stroke incidence and improvements in stroke care may also reduce population burden of dementia. Further investigations into whether temporal trends are attributable to improvements in stroke care are needed.

scholarly journals Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010–2015

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kim Rand ◽  
Fredrik Andreas Dahl ◽  
Joe Viana ◽  
Ole Morten Rønning ◽  
Kashif Waqar Faiz ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Incidence Rates ◽  
Ageing Population ◽  
Stroke Incidence ◽  
National Patient Registry ◽  
Age Dependent ◽  
National Patient ◽  
Stroke Models ◽  
Population Comparisons ◽  
Stroke Type

Abstract Background Stroke incidence rates have fallen in high-income countries over the last several decades, but findings regarding the trend over recent years have been mixed. The aim of the study was to describe and model temporal trends in incidence of stroke by age and sex between 2010 and 2015 in Norway, and to generate incidence projections towards year 2040. Methods All recorded strokes in Norway between 2010 and 2015 were extracted from the National Patient Registry and the National Cause of Death Registry. We report incidence by age, sex, and year; in raw numbers, per 100,000 person-years, by WHO and European standard populations; and generated statistical models by stroke type, age, sex, and year; and projected stroke incidence toward year 2040. Results The data covered 30.1 million person-years at risk, 53431 unique individuals hospitalized with a primary stroke diagnosis, and 6315 additional individuals registered as dead due to stroke. From 2010 to 2015, individuals suffering stroke per 100,000 person-years dropped from 239 to 195 (208 to 177 excluding immediate deaths). The decline was driven by ischemic strokes, with a statistically non-significant time trend for hemorrhagic stroke. Conclusions The age-dependent incidence of ischemic strokes in Norway is declining rapidly, and more than compensates for the growth and ageing of the population. Comparisons with historic incidence statistics show that the reduction in incidence rates has accelerated over the last two decades.

scholarly journals Colorectal Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Regional and Western Countries

2021 ◽  
Vol 28 ◽  
pp. 107327482199686
Author(s):  
Najla A. Lakkis ◽  
Ola El-Kibbi ◽  
Mona H. Osman
Keyword(s):  
Colorectal Cancer ◽  
Cancer Incidence ◽  
Temporal Trends ◽  
Incidence Rates ◽  
Steady Increase ◽  
P Value ◽  
Western Countries ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence ◽  
Males And Females

Global trends in the incidence and mortality rates of colorectal cancer show a steady increase with significant predilection to western developed countries, possibly linking it to westernized lifestyles among other risk factors. This study aims to investigate the incidence and trends of colorectal cancer in Lebanon, a country in the Middle East and North Africa region, and to compare these rates to those in regional and western countries. Colorectal cancer incidence data were extracted from the Lebanese National Cancer Registry for the currently available years 2005 to 2016. The calculated age-standardized incidence rates and age-specific rates were expressed as per 100,000 population. The age-standardized incidence rates of colorectal cancer in Lebanon increased from 16.3 and 13.0 per 100,000 in 2005 to 23.2 and 20.2 per 100,000 in 2016, among males and females, respectively. The incidences were higher for males, and they increased with age. The annual percent change was +4.36% and +4.45%, in males and females respectively (p-value < 0.05). There was a non-statistically significant trend of decrease in recent years (since 2012 in males and since 2011 in females). The age-standardized incidence rates in Lebanon were higher than those in the majority of the regional countries, but lower than the rates in developed western countries. There were high age-specific incidence rates at age groups 40-44 and 45-49 years in Lebanon in both males and females (with significant rising temporal trend) compared to other countries, including the ones reported to have the highest colorectal cancer age-standardized incidence rate worldwide. Therefore, the burden of colorectal cancer is significant in Lebanon. This raises the necessity to develop national strategies tailored to reduce colorectal cancer incidence through promoting healthy lifestyles, raising awareness, and early detection as of 40 years of age.

scholarly journals Secular trends in the incidence and prevalence of gout in Denmark from 1995 to 2015: a nationwide register-based study

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 836-839 ◽  
Author(s):  
Kristian Zobbe ◽  
Daniel Prieto-Alhambra ◽  
René Cordtz ◽  
Pil Højgaard ◽  
Jens Skøt Hindrup ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Incidence Rates ◽  
Secular Trends ◽  
Annual Incidence Rate ◽  
Danish Population ◽  
Age And Gender ◽  
National Patient Registry ◽  
National Patient ◽  
And Gender ◽  
Gender Specific

Abstract Objective To investigate temporal trends in the incidence and prevalence of gout in the adult Danish population. Methods Using the nationwide Danish National Patient Registry, we calculated the number of incident gout patients (per 100 000 person-years) within each 1 year period from 1995 to 2015 and the prevalence of gout in 2000 and 2015. Further, we calculated age- and gender-specific incidence rates of gout from 1995 to 2015. Results We identified a total of 45 685 incident gout patients (72.9% males) with a mean age of 65 years (s.d. 16) at diagnosis. In both genders, an increase in age-standardized incidence rates was observed from 32.3/100 000 (95% CI 30.7, 33.9) in 1995 to 57.5/100 000 (95% CI 55.6, 59.5) in 2015 (P < 0.001). Similar trends were observed for 8950 cases diagnosed in rheumatology departments. We likewise observed an increase in the prevalence of gout from 0.29% (95% CI 0.29, 0.30) in 2000 to 0.68% (95% CI 0.68, 0.69) in 2015. Conclusions The annual incidence rate of gout increased by almost 80% in Denmark between 1995 and 2015. The prevalence increased by nearly 130% between 2000 and 2015. Reasons for this are unknown but may include an increase in risk factors (e.g. obesity, diabetes mellitus), longer life expectancy and increased awareness of the disease among patients and/or health professionals.

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