Adelaide Stroke Incidence Study Declining Stroke Rates but Many Preventable Cardioembolic Strokes
Stroke incidence rates are in flux worldwide because of evolving risk factor prevalence, risk factor control, and population aging. Adelaide Stroke Incidence Study was performed to determine the incidence of strokes and stroke subtypes in a relatively elderly population of 148 000 people in the West...
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Veröffentlicht in: | Stroke (1970) 2013-05, Vol.44 (5), p.1226-1231 |
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container_title | Stroke (1970) |
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creator | LEYDEN, James M KLEINIG, Timothy J GREENHILL, Jennene NEWBURY, Jonathan CASTLE, Sally CRANEFIELD, Jennifer ANDERSON, Craig S CROTTY, Maria WHITFORD, Deirdre JANNES, Jim LEE, Andrew |
description | Stroke incidence rates are in flux worldwide because of evolving risk factor prevalence, risk factor control, and population aging. Adelaide Stroke Incidence Study was performed to determine the incidence of strokes and stroke subtypes in a relatively elderly population of 148 000 people in the Western suburbs of Adelaide.
All suspected strokes were identified and assessed in a 12-month period from 2009 to 2010. Standard definitions for stroke and stroke fatality were used. Ischemic stroke pathogenesis was classified by the Trial of ORG 10172 in Acute Stroke Treatment criteria.
There were 318 stroke events recorded in 301 individuals; 238 (75%) were first-in-lifetime events. Crude incidence rates for first-ever strokes were 161 per 100 000 per year overall (95% confidence interval [CI], 141-183), 176 for men (95% CI, 147-201), and 146 for women (95% CI, 120-176). Adjusted to the world population rates were 76 overall (95% CI, 59-94), 91 for men (95% CI, 73-112), and 61 for women (95% CI, 47-78). The 28-day case fatality rate for first-ever stroke was 19% (95% CI, 14-24); the majority were ischemic (84% [95% CI, 78-88]). Intracerebral hemorrhage comprised 11% (8-16), subarachnoid hemorrhage 3% (1-6), and 3% (1-6) were undetermined. Of the 258 ischemic strokes, 42% (95% CI, 36-49) were of cardioembolic pathogenesis. Atrial fibrillation accounted for 36% of all ischemic strokes, of which 85% were inadequately anticoagulated.
Stroke incidence in Adelaide has not increased compared with previous Australian studies, despite the aging population. Cardioembolic strokes are becoming a higher proportion of all ischemic strokes. |
doi_str_mv | 10.1161/STROKEAHA.113.675140 |
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All suspected strokes were identified and assessed in a 12-month period from 2009 to 2010. Standard definitions for stroke and stroke fatality were used. Ischemic stroke pathogenesis was classified by the Trial of ORG 10172 in Acute Stroke Treatment criteria.
There were 318 stroke events recorded in 301 individuals; 238 (75%) were first-in-lifetime events. Crude incidence rates for first-ever strokes were 161 per 100 000 per year overall (95% confidence interval [CI], 141-183), 176 for men (95% CI, 147-201), and 146 for women (95% CI, 120-176). Adjusted to the world population rates were 76 overall (95% CI, 59-94), 91 for men (95% CI, 73-112), and 61 for women (95% CI, 47-78). The 28-day case fatality rate for first-ever stroke was 19% (95% CI, 14-24); the majority were ischemic (84% [95% CI, 78-88]). Intracerebral hemorrhage comprised 11% (8-16), subarachnoid hemorrhage 3% (1-6), and 3% (1-6) were undetermined. Of the 258 ischemic strokes, 42% (95% CI, 36-49) were of cardioembolic pathogenesis. Atrial fibrillation accounted for 36% of all ischemic strokes, of which 85% were inadequately anticoagulated.
Stroke incidence in Adelaide has not increased compared with previous Australian studies, despite the aging population. Cardioembolic strokes are becoming a higher proportion of all ischemic strokes.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.113.675140</identifier><identifier>PMID: 23482602</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Brain Ischemia - epidemiology ; Cohort Studies ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Incidence ; Intracranial Hemorrhages - epidemiology ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Risk ; South Australia - epidemiology ; Stroke - epidemiology ; Survival Rate ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2013-05, Vol.44 (5), p.1226-1231</ispartof><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c286t-32eaee3d29932c72c821171a39a691c29cfc17d8abf0a29f49ff6b06aa83423f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27321598$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23482602$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LEYDEN, James M</creatorcontrib><creatorcontrib>KLEINIG, Timothy J</creatorcontrib><creatorcontrib>GREENHILL, Jennene</creatorcontrib><creatorcontrib>NEWBURY, Jonathan</creatorcontrib><creatorcontrib>CASTLE, Sally</creatorcontrib><creatorcontrib>CRANEFIELD, Jennifer</creatorcontrib><creatorcontrib>ANDERSON, Craig S</creatorcontrib><creatorcontrib>CROTTY, Maria</creatorcontrib><creatorcontrib>WHITFORD, Deirdre</creatorcontrib><creatorcontrib>JANNES, Jim</creatorcontrib><creatorcontrib>LEE, Andrew</creatorcontrib><title>Adelaide Stroke Incidence Study Declining Stroke Rates but Many Preventable Cardioembolic Strokes</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Stroke incidence rates are in flux worldwide because of evolving risk factor prevalence, risk factor control, and population aging. Adelaide Stroke Incidence Study was performed to determine the incidence of strokes and stroke subtypes in a relatively elderly population of 148 000 people in the Western suburbs of Adelaide.
All suspected strokes were identified and assessed in a 12-month period from 2009 to 2010. Standard definitions for stroke and stroke fatality were used. Ischemic stroke pathogenesis was classified by the Trial of ORG 10172 in Acute Stroke Treatment criteria.
There were 318 stroke events recorded in 301 individuals; 238 (75%) were first-in-lifetime events. Crude incidence rates for first-ever strokes were 161 per 100 000 per year overall (95% confidence interval [CI], 141-183), 176 for men (95% CI, 147-201), and 146 for women (95% CI, 120-176). Adjusted to the world population rates were 76 overall (95% CI, 59-94), 91 for men (95% CI, 73-112), and 61 for women (95% CI, 47-78). The 28-day case fatality rate for first-ever stroke was 19% (95% CI, 14-24); the majority were ischemic (84% [95% CI, 78-88]). Intracerebral hemorrhage comprised 11% (8-16), subarachnoid hemorrhage 3% (1-6), and 3% (1-6) were undetermined. Of the 258 ischemic strokes, 42% (95% CI, 36-49) were of cardioembolic pathogenesis. Atrial fibrillation accounted for 36% of all ischemic strokes, of which 85% were inadequately anticoagulated.
Stroke incidence in Adelaide has not increased compared with previous Australian studies, despite the aging population. Cardioembolic strokes are becoming a higher proportion of all ischemic strokes.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Brain Ischemia - epidemiology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intracranial Hemorrhages - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Risk</subject><subject>South Australia - epidemiology</subject><subject>Stroke - epidemiology</subject><subject>Survival Rate</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkNtKxDAQhoMouh7eQKQ3gjfVZJKmyeWyrgdUFA_XZZpOpNptNWmFfXsru-rV8A_fPwMfY4eCnwqhxdnT8-P9zXx6NR2jPNV5JhTfYBORgUqVBrPJJpxLm4KydoftxvjGOQdpsm22A1IZ0BwmDKcVNVhXlDz1oXun5Lp1Y2rdz2Kolsk5uaZu6_b1F3jEnmJSDn1yh-0yeQj0RW2PZUPJDENVd7Qou6Z2az7usy2PTaSD9dxjLxfz59lVent_eT2b3qYOjO5TCYREsgJrJbgcnAEhcoHSorbCgXXeibwyWHqOYL2y3uuSa0QjFUgv99jJ6u5H6D4Hin2xqKOjpsGWuiEWQqosE7k2ckTVCnWhizGQLz5CvcCwLAQvfuQWf3LHKIuV3LF2tP4wlAuq_kq_NkfgeA1gdNj4gKPM-M_lEkRmjfwGoX-DWA</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>LEYDEN, James M</creator><creator>KLEINIG, Timothy J</creator><creator>GREENHILL, Jennene</creator><creator>NEWBURY, Jonathan</creator><creator>CASTLE, Sally</creator><creator>CRANEFIELD, Jennifer</creator><creator>ANDERSON, Craig S</creator><creator>CROTTY, Maria</creator><creator>WHITFORD, Deirdre</creator><creator>JANNES, Jim</creator><creator>LEE, Andrew</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Adelaide Stroke Incidence Study Declining Stroke Rates but Many Preventable Cardioembolic Strokes</title><author>LEYDEN, James M ; KLEINIG, Timothy J ; GREENHILL, Jennene ; NEWBURY, Jonathan ; CASTLE, Sally ; CRANEFIELD, Jennifer ; ANDERSON, Craig S ; CROTTY, Maria ; WHITFORD, Deirdre ; JANNES, Jim ; LEE, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c286t-32eaee3d29932c72c821171a39a691c29cfc17d8abf0a29f49ff6b06aa83423f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Brain Ischemia - epidemiology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intracranial Hemorrhages - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Risk</topic><topic>South Australia - epidemiology</topic><topic>Stroke - epidemiology</topic><topic>Survival Rate</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LEYDEN, James M</creatorcontrib><creatorcontrib>KLEINIG, Timothy J</creatorcontrib><creatorcontrib>GREENHILL, Jennene</creatorcontrib><creatorcontrib>NEWBURY, Jonathan</creatorcontrib><creatorcontrib>CASTLE, Sally</creatorcontrib><creatorcontrib>CRANEFIELD, Jennifer</creatorcontrib><creatorcontrib>ANDERSON, Craig S</creatorcontrib><creatorcontrib>CROTTY, Maria</creatorcontrib><creatorcontrib>WHITFORD, Deirdre</creatorcontrib><creatorcontrib>JANNES, Jim</creatorcontrib><creatorcontrib>LEE, Andrew</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LEYDEN, James M</au><au>KLEINIG, Timothy J</au><au>GREENHILL, Jennene</au><au>NEWBURY, Jonathan</au><au>CASTLE, Sally</au><au>CRANEFIELD, Jennifer</au><au>ANDERSON, Craig S</au><au>CROTTY, Maria</au><au>WHITFORD, Deirdre</au><au>JANNES, Jim</au><au>LEE, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adelaide Stroke Incidence Study Declining Stroke Rates but Many Preventable Cardioembolic Strokes</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>44</volume><issue>5</issue><spage>1226</spage><epage>1231</epage><pages>1226-1231</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Stroke incidence rates are in flux worldwide because of evolving risk factor prevalence, risk factor control, and population aging. Adelaide Stroke Incidence Study was performed to determine the incidence of strokes and stroke subtypes in a relatively elderly population of 148 000 people in the Western suburbs of Adelaide.
All suspected strokes were identified and assessed in a 12-month period from 2009 to 2010. Standard definitions for stroke and stroke fatality were used. Ischemic stroke pathogenesis was classified by the Trial of ORG 10172 in Acute Stroke Treatment criteria.
There were 318 stroke events recorded in 301 individuals; 238 (75%) were first-in-lifetime events. Crude incidence rates for first-ever strokes were 161 per 100 000 per year overall (95% confidence interval [CI], 141-183), 176 for men (95% CI, 147-201), and 146 for women (95% CI, 120-176). Adjusted to the world population rates were 76 overall (95% CI, 59-94), 91 for men (95% CI, 73-112), and 61 for women (95% CI, 47-78). The 28-day case fatality rate for first-ever stroke was 19% (95% CI, 14-24); the majority were ischemic (84% [95% CI, 78-88]). Intracerebral hemorrhage comprised 11% (8-16), subarachnoid hemorrhage 3% (1-6), and 3% (1-6) were undetermined. Of the 258 ischemic strokes, 42% (95% CI, 36-49) were of cardioembolic pathogenesis. Atrial fibrillation accounted for 36% of all ischemic strokes, of which 85% were inadequately anticoagulated.
Stroke incidence in Adelaide has not increased compared with previous Australian studies, despite the aging population. Cardioembolic strokes are becoming a higher proportion of all ischemic strokes.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>23482602</pmid><doi>10.1161/STROKEAHA.113.675140</doi><tpages>6</tpages></addata></record> |
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source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Adult Aged Aged, 80 and over Biological and medical sciences Brain Ischemia - epidemiology Cohort Studies Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Incidence Intracranial Hemorrhages - epidemiology Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Risk South Australia - epidemiology Stroke - epidemiology Survival Rate Vascular diseases and vascular malformations of the nervous system |
title | Adelaide Stroke Incidence Study Declining Stroke Rates but Many Preventable Cardioembolic Strokes |
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