Global Stroke Statistics 2019

Abstract

Background Data on stroke epidemiology and availability of hospital-based stroke services around the world are important for guiding policy decisions and healthcare planning. Aims To provide the most current incidence, mortality and case–fatality data on stroke and describe current availability of stroke units around the world by country. Methods We searched multiple databases (based on our existing search strategy) to identify new original manuscripts and review articles published between 1 June 2016 and 31 October 2018 that met the ideal criteria for data on stroke incidence and case–fatality. For data on the availability of hospital-based stroke services, we searched PubMed for all literature published up until 31 June 2018. We further screened reference lists, citation history of manuscripts and gray literature for this information. Mortality codes for International Classification of Diseases-9 and International Classification of Diseases-10 were extracted from the World Health Organization mortality database for each country providing these data. Population denominators were obtained from the World Health Organization, and when these were unavailable within a two-year period of mortality data, population denominators within a two-year period were obtained from the United Nations. Using country-specific population denominators and the most recent years of mortality data available for each country, we calculated both the crude mortality from stroke and mortality adjusted to the World Health Organization world population. Results Since our last report in 2017, there were two countries with new incidence studies, China ( n = 1) and India ( n = 2) that met the ideal criteria. New data on case–fatality were found for Estonia and India. The most current mortality data were available for the year 2015 (39 countries), 2016 (43 countries), and 2017 (7 countries). No new data on mortality were available for six countries. Availability of stroke units was noted for 63 countries, and the proportion of patients treated in stroke units was reported for 35/63 countries. Conclusion Up-to-date data on stroke incidence, case–fatality, and mortality statistics provide evidence of variation among countries and changing magnitudes of burden among high and low–middle income countries. Reporting of hospital-based stroke units remains limited and should be encouraged.

Knowledge on Signs and Risk Factors in Stroke Patients

“…In order to assess a person's attitude to a possible stroke event, the following closed-ended question was asked: "If you think someone is having the symptoms of a stroke, which will be your first reaction?" The three options to choose from as a response to this question were as follows: (1) No specific action is required; (2) Treatment should be sought, although not necessarily immediately; and (3) This is an emergency and medical attention should be sought immediately; the correct one being the one which recognized the possibility of treatment and the importance of the time factor.…”

“…Strokes continue to be a global health issue and a social problem, a situation expected to worsen in the coming years as the population ages. Strokes represent one of the major causes of mortality, dependency, and long-term disability in adults, proving to be highly expensive for the patients, their families, the health services, and the community as a whole [1,2].…”

Genistein-3′-sodium Sulfonate Attenuates Cerebral Ischemia/reperfusion Injury in Rats by Down-regulating Microglial M1 Polarization Through α7nAChR-mediated Inhibition of NF-κb Signaling Pathway 

“…α7nAChR is a crucial receptor mediating cholinergic anti-in ammatory pathway. The stimulation of α7nAChR inhibits the activation of NF-κB signaling in microglia, reduced M1 microglia in the peri-infarct brain regions, and reduced brain injury in permanent MCAO (pMCAO)mice [2] [25] . In this study, we found that α7nAChR protein expression signi cantly decreased in the ischemic penumbra regions in tMCAO rats, while it was restored by GSS treatment.…”

Neuroprotective effect of Indobufen against pyroptosis following cerebral ischemia-reperfusion injury both in vivo and in vitro

“…Stroke is characterized by high morbidity and disability rate, and is also one of the deadliest diseases globally [1]. Ischemic stroke occupy the vast majority of stroke caused by blockage of blood circulation to the brain, resulting in pathophysiologic events like excitatory amino acids toxicity, ion imbalances and oxidative stress, leading to accumulation of hypoxia and toxic substances such as in ammatory cytokines, as well as the death of brain cells, and may induce subsequent neurobehavioral de cits in stroke survivors.…”