Trends in hospitalized stroke for blacks and whites in the United States, 1980-1999
Trends in hospitalized stroke for blacks and whites in the United States, 1980-1999
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DOI：
10.1159/000054810
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发表时间：
2002-05-01
影响因子：
5.7
通讯作者：
Vaccarino, V
中科院分区：
文献类型：
--
作者：
Kennedy, BS;Kasl, SV;Vaccarino, V
背景：脑卒中死亡率的种族差异已被广泛认识，但尚不清楚这些差异是否主要是由于黑人与白人相比中风发病率更高或病死率更高。目的：本研究的目的是描述1980-1999年期间美国特定种族中风患者出院率和住院死亡率的趋势。假设黑人中风患者的出院率和住院死亡率高于白人。方法：根据《国际疾病分类》第九版代码（代码430-434和436），采用1980-1999年全国医院出院调查数据确定卒中受试者。采用直接标准化和泊松回归比较黑人和白人住院卒中发病率和死亡率。主要结局指标是黑人和白人中风患者的中风出院人数和住院死亡人数。结果：1980年至1999年间，黑人中风出院率上升（8700例），白人中风出院率下降（46154例）；黑人和白人中风患者的住院死亡率都有所下降。一般来说，黑人中风住院的风险比白人高出70%以上，而两组中风患者的住院死亡率相似。结论：黑人和白人在脑卒中死亡率方面的差异更可能是由于脑卒中发病率的差异，而不是病死率的差异。这些数据表明，应更加重视一级/二级预防，并需要进一步研究以了解这些模式的原因。版权所有(C) 2002 S. Karger AG，巴塞尔。
Background: Racial differences in stroke mortality are widely recognized, but it is unclear whether or not these differences are due mainly to blacks having a greater stroke incidence or higher case fatality rates compared to those of whites. Objectives: The aim of this study was to describe the race-specific US trends in hospital discharge rates and in-hospital mortality among stroke patients for the period 1980-1999. It was hypothesized that the hospital discharge rates and in-hospital mortality among stroke patients would be greater for blacks than for whites. Methods: Data from the National Hospital Discharge Survey for the period 1980-1999 were used to identify stroke subjects according to the codes of the International Classification of Diseases, ninth revision (codes 430-434 and 436). Direct standardization and Poisson regression were used to compare hospitalized stroke morbidity and mortality rates between blacks and whites. The main outcome measures were the number of stroke discharges and in-hospital deaths for black and white stroke patients. Results: Between the years 1980 and 1999, the hospital discharge rates for stroke increased for blacks (n = 8,700) and decreased for whites (n = 46,154); the in-hospital mortality rates decreased for both black and white stroke patients. Generally, the risk of a stroke hospitalization was greater for blacks than for whites by more than 70%, whereas both groups were similar in terms of in-hospital mortality rates among stroke patients. Conclusions: Differences between blacks and whites in terms of stroke mortality are more likely due to differences in stroke incidence rather than case fatality. These data imply that greater attention should be given to primary/secondary prevention and that additional research is needed to understand the reasons for these patterns. Copyright (C) 2002 S. Karger AG, Basel.