Incidence and mortality of cerebrovascular disease in Spain: 1,600,000 hospital admissions between 2001 and 2015

Abstract

Background: To analyze the incidence and mortality of cerebrovascular diseases (CeVD) in Spain from 2001 to 2015. Methods: Retrospective study of hospital incidence, hospital case-fatality and population mortality, with records from the Spanish Government Statistics. Days of hospital stay and risk of death during admission (RD) were estimated adjusting for age, sex, first stroke (FS), atrial fibrillation (AF), diabetes, hypertension, and smoking. Results: There were 1,662,487 stroke cases older than 15 years of age admitted to hospital (1,096,748 FS), with a national incidence = 291/105 in this period (Murcia maximum [367/105], Canary Islands minimum [238/105]). Population mortality (-50%) decreased while case-fatality remained stable (-3%), despite the increase in the age of patients (+2.29 years) and the incidence (+25%). Canary Islands had the youngest patients (-3.5 years for men and -6 years for women) and the longest hospital stay (+5.1 days). Andalusia (OR= 1.21 [1.19; 1.22]) and the Canaries (OR= 1.18 [1.15; 1.21]) had the highest RD. The factors associated to the highest increases in RD were FS (OR = 1.34 [95%CI= 1.33-1.35]) and AF (OR = 1.30 [95%CI= 1.29-1.31]). Conclusions: Population mortality due to CeVD was reduced by half in Spain between 2001 and 2015, but hospital incidence increased. Andalusia and the Canary Islands had the highest RD in the country. These Islands presented the lowest incidence, but their patients were younger, and their hospital stay longer. FS and AF were the factors associated with a higher risk of death.

The global impact of stroke in 2022

“…A further paper in this month’s issue analyzed the incidence and mortality of cerebrovascular disease in Spain from 2001 to 2015. 4 Reassuringly, it was found that stroke mortality reduced by half in Spain over this period, consistent with many studies from other high-income countries. 5 These show that a combination of public health measures, and better primary prevention, can reduce incidence of stroke and cardiovascular disease and emphasises the importance of developing such approaches globally, including in LMIC.…”