Trends in stroke hospitalisation rates in Extremadura between 2002 and 2014: Changing the notion of stroke as a disease of the elderly

Ramírez-Moreno, J.M.; Félix-Redondo, Francisco Javier; Fernández-Bergés, Daniel; Lozano-Mera, L.

doi:10.1016/j.nrleng.2016.09.002

Cited by 5 publications

(8 citation statements)

References 24 publications

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“…The specificity found in our study was 94.51%, and the NPV was 97.64%, similar to those found by Baldereschi et (28). The few prevalence studies found show great variability with respect to terminology, definition, and methodology, as well as in the age groups assessed (29) (30) (31).…”

Section: Discussionsupporting

confidence: 90%

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Validation of diagnosis of acute myocardial infarction and stroke in electronic medical records: a primary care cross-sectional study in Madrid, Spain (the e-MADVEVA Study)

Burgos‐Lunar

del-Cura-González

Cárdenas‐Valladolid

et al. 2022

Preprint

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Objectives: To validate the diagnoses of AMI and stroke recorded in EMR and to estimate the population prevalence of both diseases in people aged ≥ 18 years Design: Cross-sectional validation study Setting: 45 primary care centres Participants: Simple random sampling of diagnoses of AMI and stroke (ICPC-2 codes K75 and K90, respectively) registered by 55 physicians and random age- and sex-matched sampling of the records that included in primary care EMRs in Madrid (Spain). Primary and Secondary Outcomes Measures: Sensitivity, specificity, positive and negative predictive values, and overall agreement were calculated using the kappa statistic. Applied gold standards were electrocardiograms, brain imaging studies, hospital discharge reports, cardiology reports, and neurology reports. In the case of AMI, the ESC/ACCF/AHA/WHF Expert Consensus Document was also used. Secondary outcomes were the estimated prevalence of both diseases considering the sensitivity and specificity obtained (true prevalence). Results: The sensitivity of a diagnosis of AMI was 98.11% (95% CI, 96.29-99.03), and the specificity was 97.42% (95% CI, 95.44-98.55). The sensitivity of a diagnosis of stroke was 97.56% (95% CI, 95.56-98.68), and the specificity was 94.51% (95% CI, 91.96-96.28). No differences in the results were found after stratification by age and sex (both diseases). The prevalence of AMI and stroke was 1.38% and 1.27%, respectively. Conclusion: The validation results show that diagnoses of AMI and stroke in primary care EMRs constitute a helpful tool in epidemiological studies. The prevalence of AMI and stroke was lower than 2% in the population aged over 18 years.

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Section: Discussionsupporting

confidence: 90%

“…Most epidemiological studies on AMI and stroke in Spain estimate incidence, hospital admissions, and mortality (24) (25) (26) (27) (28). The few prevalence studies found show great variability with respect to terminology, definition, and methodology, as well as in the age groups assessed (29) (30) (31).…”

Section: Discussionmentioning

confidence: 99%

Validation of diagnosis of acute myocardial infarction and stroke in electronic medical records: a primary care cross-sectional study in Madrid, Spain (the e-MADVEVA Study)

Burgos‐Lunar

del-Cura-González

Cárdenas‐Valladolid

et al. 2022

Preprint

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“…7 On the contrary, studies that, such as the case of this study, use the MBDS find an increase in hospitalizations for stroke in Spain. 8 The possibility that hospital incidence has increased simply due to an improvement in the MBDS records during the 15 years studied is an unlikely hypothesis since the exception of Cantabria contradict this and, on the contrary, previous studies of other vascular diseases in the MBDS found decreasing incidences in similar periods. 13 Rather, this increase in hospital incidence could be due to the fact that, as a result of the aforementioned health improvements, the number of patients who are admitted alive to hospitals after suffering a stroke has increased.…”

Section: Discussionmentioning

confidence: 83%

“…1,7 Logically, the trend varies between countries depending on their policies and their level of development. 4,8 It is foreseeable that the absolute numbers of stroke will increase in developed countries in the coming years as a consequence of the increase in life expectancy. 7 The incidence of CeVD in Spain is higher than in England, Germany, and France, but lower than in other neighboring countries such as Italy, Greece, or Portugal.…”

Section: Introductionmentioning

confidence: 99%

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

Hernández

Pérez

Rodríguez

et al. 2022

International Journal of Stroke

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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.

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Diverging Temporal Trends in Stroke Incidence in Younger vs Older People

Scott

Rothwell

2022

JAMA Neurol

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ImportanceOverall stroke incidence is falling in high-income countries, but data on time trends in incidence of young stroke (ie, stroke in individuals younger than 55 years) are conflicting. An age-specific divergence in incidence, with less favorable trends at younger vs older ages, might be a more consistent underlying finding across studies.ObjectiveTo compare temporal trends in incidence of stroke at younger vs older ages in high-income countries.Data SourcesPubMed and EMBASE were searched from inception to February 2022. One additional population-based study (Oxford Vascular Study) was also included.Study SelectionStudies reporting age-specific stroke incidence in high-income countries at more than 1 time point.Data Extraction and SynthesisFor all retrieved studies, 2 authors independently reviewed the full text against the inclusion criteria to establish their eligibility. Meta-analysis was performed with the inverse variance–weighted random-effects model. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed.Main Outcomes and MeasuresThe main outcome was age-specific divergence (&lt;55 vs ≥55 years) in temporal trends in stroke incidence (relative temporal rate ratio [RTTR]) in studies extending to at least 2000. RTTRs were calculated for each study and pooled by random-effects meta-analysis, with stratification by administrative vs prospective population-based methodology, sex, stroke subtype (ischemic vs intracerebral hemorrhage vs subarachnoid hemorrhage) and geographical region.ResultsAmong 50 studies in 20 countries, 26 (13 prospective population-based and 13 administrative studies) reported data allowing calculation of the RTTR for stroke incidence at younger vs older ages across 2 or more periods, the latest extending beyond 2000. Reported trends in absolute incidence of young individuals with stroke were heterogeneous, but all studies showed a less favorable trend in incidence at younger vs older ages (pooled RTTR = 1.57 [95% CI, 1.42-1.74]). The overall RTTR was consistent by stroke subtype (ischemic, 1.62 [95% CI, 1.44-1.83]; intracerebral hemorrhage, 1.32 [95% CI, 0.91-1.92]; subarachnoid hemorrhage, 1.54 [95% CI, 1.00-2.35]); and by sex (men, 1.46 [95% CI, 1.34-1.60]; women, 1.41 [95% CI, 1.28-1.55]) but was greater in studies reporting trends solely after 2000 (1.51 [95% CI, 1.30-1.70]) vs solely before (1.18 [95% CI, 1.12-1.24]) and was highest in population-based studies in which the most recent reported period of ascertainment started after 2010 (1.87 [95% CI, 1.55-2.27]).Conclusions and RelevanceTemporal trends in stroke incidence are diverging by age in high-income countries, with less favorable trends at younger vs older ages, highlighting the urgent need to better understand etiology and prevention of stroke at younger ages.

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Trends in stroke hospitalisation rates in Extremadura between 2002 and 2014: Changing the notion of stroke as a disease of the elderly

Cited by 5 publications

References 24 publications

Validation of diagnosis of acute myocardial infarction and stroke in electronic medical records: a primary care cross-sectional study in Madrid, Spain (the e-MADVEVA Study)

Validation of diagnosis of acute myocardial infarction and stroke in electronic medical records: a primary care cross-sectional study in Madrid, Spain (the e-MADVEVA Study)

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

Diverging Temporal Trends in Stroke Incidence in Younger vs Older People

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