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Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010-2015.

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.

SUBMITTER: Rand K

PROVIDER: S-EPMC6796379 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010-2015.

Rand Kim K Dahl Fredrik Andreas FA Viana Joe J Rønning Ole Morten OM Faiz Kashif Waqar KW Barra Mathias M

BMC health services research 20191016 1

<h4>Background</h4>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.<h4>Methods</h4>All recorded strokes in Norway between 2010 and 2015 were extracted from the National Patient Registry and the Natio ...[more]

PMID: 31619227

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Project description:BackgroundEsophageal cancer is among the leading cancer types in Inner Mongolia. This study aimed to investigate the incidence and mortality rates of esophageal cancer in 2015 and the trends in these rates in the 2010-2015 period in this region.MethodsNational Colorectal Cancer Roundtable (NCCR) screening methods and criteria were used to extract data from 10 cancer registries stratified by area (urban/rural), sex, and age group. The Chinese standard population in 2000 and Segi's world population were used to calculate age-standardized rates. The annual percentage change (APC) in these rates was calculated using the Joinpoint Regression Program.ResultsIn 2015, Inner Mongolia had 4324 new cases (4027 male vs. 297 female patients) and 3559 deaths (3300 male vs. 259 female patients) from esophageal cancer. The crude incidence, age-standardized incidence by Chinese population, age-standardized incidence by world population, and cumulative incidence were 13.45/100 000, 9.92/100 000, 10.18/100 000, and 1.30%, respectively. The corresponding figures for mortality were 11.32/100 000, 8.35/100 000, 8.53/100 000, and 1.04%. The incidence and mortality increased with age between 40 and 80 years. The rates in rural dwellers, especially men, showed negative APC (-13.25% vs. -11.08%; P < 0.05).ConclusionsThe incidence and mortality rates of esophageal cancer in Inner Mongolia increased between 2010 and 2015. The rates were higher in men in rural areas, middle-aged and elderly individuals. Prevention and control programs focused on these groups, in addition to early diagnosis and treatment of esophageal cancer, are needed to reduce these rates.Key pointsSignificant findings of the study: In Inner Mongolia, incidence and mortality rates of esophageal cancer were higher in urban areas than in rural areas and in men than in women between 2010 and 2015, and in middle-aged and elderly than in younger people.What this study addsPrevention and control programs, in addition to early diagnosis and treatment of esophageal cancer, should be tailored to specifically target men in rural areas and middle-aged and elderly individuals in order to reduce the incidence and mortality rates of this pathology.

Project description:High revascularization rates in large-vessel occlusion strokes treated by mechanical thrombectomy are not always associated with good clinical outcomes. We evaluated predictors of functional dependence despite successful revascularization among patients with acute ischemic stroke treated with thrombectomy.We analyzed the pooled data from the Multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI), Thrombectomy Revascularization of Large Vessel Occlusions in Acute Ischemic Stroke (TREVO), and TREVO 2 trials. Successful revascularization was defined as thrombolysis in cerebral infarction score 2b or 3. Functional dependence was defined as a score of 3 to 6 on the modified Rankin Scale at 3 months. We assessed relationship of demographic, clinical, angiographic characteristics, and hemorrhage with functional dependence despite successful revascularization.Two hundred and twenty-eight patients with successful revascularization had clinical outcome follow-up. The rates of functional dependence with endovascular success were 48.6% for Trevo thrombectomy and 58.0% for Merci thrombectomy. Age (odds ratio, 1.04; 95% confidence interval, 1.02-1.06 per 1-year increase), National Institutes of Health Stroke Scale score (odds ratio, 1.08; 95% confidence interval, 1.02-1.15 per 1-point increase), and symptom onset to endovascular treatment time (odds ratio, 1.11; 95% confidence interval, 1.01-1.22 per 30-minute delay) were predictors of functional dependence despite successful revascularization. Symptom onset to reperfusion time beyond 5 hours was associated with functional dependence. All subjects with symptomatic intracranial hemorrhage had functional dependence.One half of patients with successful mechanical thrombectomy do not have good outcomes. Age, severe neurological deficits, and delayed endovascular treatment were associated with functional dependence despite successful revascularization. Our data support efforts to minimize delays to endovascular therapy in patients with acute ischemic stroke to improve outcomes.http://www.clinicaltrials.gov. Unique identifier: NCT00318071, NCT01088672, and NCT01270867.

Dataset Information

Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010-2015.

Publications

Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010-2015.

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