Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989.
Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989.
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发表时间：
1996-03
期刊：
影响因子：
8.3
通讯作者：
Robert D. Brown;J. Whisnant;J. Sicks;W. O'fallon;D. Wiebers
中科院分区：
文献类型：
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作者：
Robert D. Brown;J. Whisnant;J. Sicks;W. O'fallon;D. Wiebers
背景和目的全世界只有少数几个研究中心提供了卒中发病率和死亡率的趋势。明尼苏达州罗切斯特患者医疗护理的独特性质使得可以确定自1955年以来社区居民的几乎所有中风病例。本研究更新了1989年以来的发病率、卒中死亡率、放射成像可用性、卒中和卒中亚型的患病率，并评估了1955年以来的趋势。方法：对截至1989年12月31日的5年期间所有可能诊断为卒中的罗切斯特居民的病历进行筛选，以确定病例是否符合卒中标准。使用所有可用数据确定卒中类型。计算了1955年至1989年5年间年龄和性别校正的卒中和各种类型卒中的年平均发病率。中风的患病率也被确定。Poisson回归用于更好地阐明卒中发生率对多个变量的依赖性。考克斯比例风险模型评价了短期和长期卒中生存率的趋势。结果1985 ~ 1989年罗切斯特居民脑卒中发病496例。年龄和性别校正的卒中年发病率为145/10万人，从1980年至1984年几乎没有变化，比1975年至1979年确定的发病率高13%。与1970年代相比，在54岁以上的所有年龄组和男女中，发病率都有所增加。从1955年开始，脑梗死后的生存率与年龄和日历年有关。脑实质内出血的年发病率是蛛网膜下腔出血的2倍。结论：与20世纪70年代相比，中风的发病率仍然很高。尽管据报道未经治疗的高血压的发生率稳定或下降，但卒中的发生率高于20世纪60年代和70年代卒中发生率下降期间的发生率。除了放射成像的影响、缺血性心脏病患者的增加以及可能检测到轻度卒中病例外，其他未确定的因素可能导致过去10年检测到的卒中发病率增加。
BACKGROUND AND PURPOSE Trends in stroke incidence and mortality are available from few sites worldwide. The unique nature of the medical care in patients from Rochester, Minn, has allowed the ascertainment of virtually all cases of stroke for community residents for the period dating from 1955. This study updates incidence rates, stroke mortality, radiological imaging availability, and prevalence for stroke and subtypes of stroke though 1989 and evaluates trends since 1955. METHODS Medical records of all residents of Rochester with potential diagnosis of stroke during the 5-year period through December 31, 1989 were screened to determine whether the case met the criteria for stroke. The type of stroke was determined with the use of all available data. Average annual age- and sex-adjusted incidence rates for stroke and various types of stroke were calculated for 5-year periods from 1955 to 1989. Prevalence of stroke was also determined. Poisson regression was used to better clarify the dependence of stroke incidence on multiple variables. Cox proportional hazards modeling evaluated trends in short-term and long-term stroke survival. RESULTS We found that 496 incidence cases of stroke occurred among Rochester residents during 1985 to 1989. The annual age- and sex-adjusted stroke incidence rates was 145 per 100 000 population, which was virtually unchanged from 1980 to 1984 and 13% higher than the rate determined in 1975 to 1979. Increasing incidence rates compared with the 1970s were noted in all groups aged older than 54 years and in both sexes. Survival after cerebral infarction was dependent on age and calendar year when trends dating from 1955 were evaluated. The annual incidence rate of intraparenchymal hemorrhage was twice that of subarachnoid hemorrhage. CONCLUSIONS Incidence rates for stroke have remained at a high rate than those determined in the 1970s. Although the occurrence of untreated hypertension has been reported to be stable or decreasing, the incidence rate of stroke is higher than those noted during the decline in stroke incidence during the 1960s and 1970s. In addition to the impact of radiological imaging, increased contribution of patients with ischemic heart disease, and the possible detection of milder cases of stroke, other factors, which are undefined, may be contributing to the increased stroke incidence rates detected over the last 10 years.