OBJECTIVE: To estimate changes in rates of cerebral infarction and intracerebral hemorrhage, comorbidity profile, and case fatality rates in Quebec over 15 years. METHODS: A population-based admission-to-discharge cohort study was conducted, selecting first stroke events from hospital discharge data (MedEcho) from 1988 to 2002. RESULTS: In this study (involving 101,831 persons with cerebral infarctions and 11,215 persons with intracerebral hemorrhages), there was a downturn in the rates of cerebral infarction over 15 years, especially during the last 5 years (32.5% decline for men and 25.5% for women). A concomitant increase in rates of intracerebral hemorrhage, 28% increase for men (2%/year) and 22% for women (1.6%/year), was also noted. Although age and comorbidity of the population increased, case fatality decreased over time. Age and type of stroke were strong predictors for early (< or =7 days) and later (8 to 30 days) case fatality, whereas comorbidity was important only for later death. In-hospital bed stay declined dramatically over time for all discharge destinations. CONCLUSIONS: A significant decrease in rates of cerebral infarction and a rise in rates of intracerebral hemorrhage were noted in Quebec over 15 years. Age and comorbidity of the population increased. Although stroke is increasingly a condition of the elderly, ill population, case fatality and in-hospital bed stay declined over time.
OBJECTIVE: To estimate changes in rates of cerebral infarction and intracerebral hemorrhage, comorbidity profile, and case fatality rates in Quebec over 15 years. METHODS: A population-based admission-to-discharge cohort study was conducted, selecting first stroke events from hospital discharge data (MedEcho) from 1988 to 2002. RESULTS: In this study (involving 101,831 persons with cerebral infarctions and 11,215 persons with intracerebral hemorrhages), there was a downturn in the rates of cerebral infarction over 15 years, especially during the last 5 years (32.5% decline for men and 25.5% for women). A concomitant increase in rates of intracerebral hemorrhage, 28% increase for men (2%/year) and 22% for women (1.6%/year), was also noted. Although age and comorbidity of the population increased, case fatality decreased over time. Age and type of stroke were strong predictors for early (< or =7 days) and later (8 to 30 days) case fatality, whereas comorbidity was important only for later death. In-hospital bed stay declined dramatically over time for all discharge destinations. CONCLUSIONS: A significant decrease in rates of cerebral infarction and a rise in rates of intracerebral hemorrhage were noted in Quebec over 15 years. Age and comorbidity of the population increased. Although stroke is increasingly a condition of the elderly, ill population, case fatality and in-hospital bed stay declined over time.
Authors: Daniel Woo; Guido J Falcone; William J Devan; W Mark Brown; Alessandro Biffi; Timothy D Howard; Christopher D Anderson; H Bart Brouwers; Valerie Valant; Thomas W K Battey; Farid Radmanesh; Miriam R Raffeld; Sylvia Baedorf-Kassis; Ranjan Deka; Jessica G Woo; Lisa J Martin; Mary Haverbusch; Charles J Moomaw; Guangyun Sun; Joseph P Broderick; Matthew L Flaherty; Sharyl R Martini; Dawn O Kleindorfer; Brett Kissela; Mary E Comeau; Jeremiasz M Jagiella; Helena Schmidt; Paul Freudenberger; Alexander Pichler; Christian Enzinger; Björn M Hansen; Bo Norrving; Jordi Jimenez-Conde; Eva Giralt-Steinhauer; Roberto Elosua; Elisa Cuadrado-Godia; Carolina Soriano; Jaume Roquer; Peter Kraft; Alison M Ayres; Kristin Schwab; Jacob L McCauley; Joanna Pera; Andrzej Urbanik; Natalia S Rost; Joshua N Goldstein; Anand Viswanathan; Eva-Maria Stögerer; David L Tirschwell; Magdy Selim; Devin L Brown; Scott L Silliman; Bradford B Worrall; James F Meschia; Chelsea S Kidwell; Joan Montaner; Israel Fernandez-Cadenas; Pilar Delgado; Rainer Malik; Martin Dichgans; Steven M Greenberg; Peter M Rothwell; Arne Lindgren; Agnieszka Slowik; Reinhold Schmidt; Carl D Langefeld; Jonathan Rosand Journal: Am J Hum Genet Date: 2014-03-20 Impact factor: 11.025