Population-based stroke surveillance using Big Data: epidemiological trends in admissions and mortality in Australia

Abstract

<jats:p>Background: Epidemiological trends for major causes of death and disability, such as stroke, may be monitored using administrative data to guide public health initiatives and service delivery. Methods: We calculated admissions rates for ischaemic stroke, intracerebral haemorrhage or subarachnoid haemorrhage between January 1, 2005 and December 31st, 2013 and rates of 30-day mortality and 365-day mortality in 30-day survivors to December 31st 2014 for patients aged 15 years or older from New South Wales, Australia (population 7.99 million). Annual Average Percentage Change in rates was estimated using negative binomial regression. Results: Of 81,703 eligible admissions, 64,047 (78.4%) were ischaemic strokes and 13,302 (16.3%) and 4,778 (5.8%) were intracerebral and subarachnoid haemorrhages, respectively. Intracerebral haemorrhage admissions significantly declined by an average of 2.2% annually (95% Confidence Interval=-3.5% to -0.9%) (p&lt;0.001). Thirty-day mortality rates significantly declined for ischaemic stroke (Average Percentage Change -2.9%, 95% Confidence Interval=-5.2% to -1.0%) (p=0.004) and subarachnoid haemorrhage (Average Percentage Change=-2.6%, 95% Confidence Interval=-4.8% to -0.2%) (p=0.04). Mortality at 365-days amongst 30-day survivors of ischaemic stroke and intracerebral haemorrhage was stable over time and increased in 30-day survivors of subarachnoid haemorrhage (Annual Percentage Change 6.2%, 95% Confidence Interval=-0.1% to 12.8%), although the increase was not statistically significant (p=0.05). Conclusion: Improved prevention may have underpinned declining intracerebral haemorrhage rates while gains in survival suggest that innovations in stroke care are being successfully translated. Longer-term mortality in patients surviving the acute period is unchanged and may be increasing for subarachnoid haemorrhage warranting investment in post-discharge care and secondary prevention.</jats:p>

The Survival Status and Predictors of Mortality Among Stroke Patients at North West Ethiopia

“…[15][16][17] In the same year in Asia (41.2%), 18 in Europe (19%), 19 and in Australia (14.9%) of the stroke admission died. 20 In Africa, the burden of stroke is high and ranges from 29% to 84% of stroke-related deaths and 14.3% of the disabled. 16,21,22 Stroke prevalence was higher among young people (65 years) in high-income countries (21.8%) than in lowincome countries (15.7%).…”

“…The prevalence of strokes in Africa ranges from 15 per 100,000 in Ethiopia, to 963 per 100,000 in Egypt and 1460 per 100,000 in the Niger Delta region. 24 In Ethiopia, the burden of stroke is increasing and has become the reason for 7.5% to 19.3% of hospital admission, 5,8,14,20,39 and approximately (11% to 42.8%) death between (2014-2019). 5,8,11,13,20,27,33,[40][41][42][43][44][45] Among the consequences of stroke were, among others, sudden death and depression (12.4% to 42.9%).…”

“…24 In Ethiopia, the burden of stroke is increasing and has become the reason for 7.5% to 19.3% of hospital admission, 5,8,14,20,39 and approximately (11% to 42.8%) death between (2014-2019). 5,8,11,13,20,27,33,[40][41][42][43][44][45] Among the consequences of stroke were, among others, sudden death and depression (12.4% to 42.9%). 13,25 The wide range of medical complications of stroke are 16.5% to 27.6% of brain edema, 26,27 22.9% speech alteration, 3.5% bedsores, deep venous thrombosis (DVT) 4.1% because of immobility from stroke, 13 increased intracranial pressure (16.5%_26.1%) infection 5.9-21.1% and Seizure.…”

“… 15–17 In the same year in Asia (41.2%), 18 in Europe (19%), 19 and in Australia (14.9%) of the stroke admission died. 20 In Africa, the burden of stroke is high and ranges from 29% to 84% of stroke-related deaths and 14.3% of the disabled. 16 , 21 , 22 …”

“…In Ethiopia, the burden of stroke is increasing and has become the reason for 7.5% to 19.3% of hospital admission, 5 , 8 , 14 , 20 , 39 and approximately (11% to 42.8%) death between (2014–2019). 5 , 8 , 11 , 13 , 20 , 27 , 33 , 40–45 …”