Time trends in incidence, comorbidity, and mortality of ischemic stroke in Denmark (1996–2016)

Abstract

ObjectiveTo examine whether the incidence, comorbidity, and mortality of first-time ischemic stroke changed in Denmark between 1996 and 2016 overall and according to age and sex using a nationwide cohort design.MethodsIn this cohort study, 224,617 individuals ≥18 years admitted with first-time ischemic stroke between 1996 and 2016 were identified using Danish nationwide registries. We calculated annual age-standardized incidence rates and absolute 30-day and 1-year mortality risks. Further, we calculated annual incidence rate ratios using Poisson regression, odds ratios for 30-day mortality using logistic regression, and hazard ratios for 1-year mortality using Cox regression.ResultsThe overall age-standardized incidence rates of ischemic stroke per 1,000 person-years increased from 1996 (2.70 [95% CI, 2.65–2.76]) to 2002 (3.25 [95% CI, 3.20–3.31]) and then gradually decreased to below the initial level until 2016 (1.99 [95% CI, 1.95–2.02]). Men had higher incidence rates than women in all age groups except 18–34 and ≥85 years. Absolute mortality risk decreased between 1996 and 2016 (30-day mortality from 17.1% to 7.6% and 1-year mortality from 30.9% to 17.3%). Women between 55 and 64 and ≥85 years had higher mortality than men. Similar trends were observed for all analyses after multivariable adjustment. The prevalence of atrial fibrillation, hypertension, diabetes mellitus, and use of lipid-lowering medication increased during the study period.ConclusionsThe age-standardized incidence of first-time hospitalization for ischemic stroke increased from 1996 to 2002 and then gradually decreased to below the initial level until 2016. Absolute 30-day and 1-year mortality risks decreased between 1996 and 2016. These findings correspond to increased stroke prevention awareness and introduction of new treatments during the study period.

Temporal Trend of Comorbidity and Increasing Impacts on Mortality, Length of Stay, and Hospital Costs of First Stroke in Tianjin, North of China

“…We observed that tendency of comorbidity increasing and aging populations was in line with the study in a developed country of Denmark 8,9 . While a more serious aging trend in Denmark was observed with the predominance of rst-stroke people aged ≥ 70 years (almost 63%), and patients aged 65 years old was the dominant for those with ischemic stroke.…”

Temporal trend of comorbidity and increasing impacts on mortality, length of stay, and hospital costs of first stroke in Tianjin, North of China

“…We observed that tendency of comorbidity increasing and aging populations was in line with the study in a developed country of Denmark [ 9 , 10 ]. While a more serious aging trend in Denmark was observed with the predominance of first-stroke people aged ≥ 70 years (almost 63%), and patients aged 65 years old was the dominant for those with ischemic stroke.…”

“…Alongside this, the hazard factors of stroke also affect prevalence of many chronic diseases (e.g., myocardial infarction, diabetes, chronic obstructive pulmonary disease, and cancer). Previous studies conducted in developed countries illustrated comorbidity is a strong factor affecting short- and long-term mortality of post-stroke [ 9 , 10 ], as well as economic burden in admission [ 11 ]. However, few studies are devoted to the relationship between stroke and comorbidity in the condition of an aging population with increasing prevalence of comorbidity in China.…”

Location of death among patients presenting with cardiovascular disease to the emergency department in the United states

“…A study of time trends in Demark found that first‐time hospitalization for ischemic stroke increased from 1996 to 2002 and then gradually decreased to below the initial level until 2016 29 . In the current study, we found that there were 89 077 unweighted cases of stroke in 2006 which increased to 113 749 in 2014.…”