Annual incidence of first silent stroke in the United States: A preliminary estimate
Annual incidence of first silent stroke in the United States: A preliminary estimate
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DOI：
10.1159/000071128
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发表时间：
2003-01-01
影响因子：
2.9
通讯作者：
Saver, JL
中科院分区：
文献类型：
--
作者：
Leary, MC;Saver, JL
背景资料。最近对美国中风发病率的估计在每年760,000到78,000之间，然而这些估计并没有反映无症状的梗塞和出血的发病率。由于基于人群的研究表明，静止性卒中的患病率显著高于症状性卒中，仅基于症状性事件对卒中发病率的估计可能大大低估了每年的卒中负担。方法：从美国两项基于人群的MRI研究中提取不同年龄段的无症状性脑梗塞的患病率，这两项研究分别是社区动脉粥样硬化风险研究和心血管健康研究。同样，首次无症状脑出血发生率是根据奥地利卒中预防研究中基于人群的MRI患病率观察得出的。这些研究中的患病率观察和美国人口普查的死亡率被输入以计算特定年龄的首次无症状MRI梗塞和出血发生率。年龄特定的发病率被预测到1998年美国人口年龄队列中，以计算首次无症状MRI缺血性中风和首次无症状MRI脑出血的年度负担。结果：首次无症状MRI梗死组的估计年发病率(每100,000人)从30-39岁组的1600人到75-79岁组的16,400人不等。首次无症状MRI脑出血的估计发病率从30-39岁的180人到85岁的6,900人不等。总体而言，预计1998年美国首次无症状磁共振脑梗塞的年发病率为9040,000例，首次无症状磁共振出血为1,940,000例。结论：1998年，美国有1100多万人经历了中风，其中大约77万人有症状，1100万人首次出现无症状的MRI梗塞或出血。这些发现表明，中风的发生率大大高于仅基于临床明显事件的估计所建议的水平。版权所有(C)2003 S.Karger AG，巴塞尔。
Background. Recent estimates of stroke incidence in the US range from 760,000 to 780,000 annually, however these estimates do not reflect the incidence of silent infarcts and hemorrhages. Since population-based studies indicate the prevalence of silent stroke is substantially higher than that of symptomatic stroke, estimates of stroke incidence based solely on symptomatic events may substantially underestimate the annual stroke burden. Methods:The prevalence of silent infarcts for different age strata were abstracted from two US population-based MRI studies, the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study. Similarly, first silent cerebral hemorrhage incidence rates were derived from population-based MRI prevalence observations in the Austrian Stroke Prevention Study. Prevalence observations in these studies and death rates from the US Census were inputted to calculate age-specific first silent MRI infarct and hemorrhage incidence. Age-specific incidence rates were projected onto 1998 US population age cohorts to calculate the annual burden of first silent MRI ischemic stroke and first silent MRI cerebral hemorrhage. Results: Estimated age-specific annual incidence rates (per 100,000) of persons experiencing first silent MRI infarct ranged from 1,600 in the age 30-39 stratum to 16,400 at ages 75-79. Estimated incidence rates of first silent MRI cerebral hemorrhage ranged from 180 in the ages 30-39 to 6,900 at age >85. Overall, the projected annual incidence in 1998 of US individuals experiencing first silent MRI infarct was 9,040,000, and first silent MRI hemorrhage 1,940,000. Conclusions: In 1998, more than 11 million persons experienced stroke in the US, in whom approximately 770,000 were symptomatic and 11 million were first-ever silent MRI infarcts or hemorrhages. These findings demonstrate the incidence of stroke is substantially higher than suggested by estimates based solely on clinically manifest events. Copyright (C) 2003 S. Karger AG, Basel.