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The evolution of stroke in Quebec: a 15-year perspective
Nancy E Mayo1, Lyne Nadeau, Stella S Daskalopoulou
1Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada. nancy.mayo@mcgill.ca
Neurology
|April 4, 2007
Summary
Cerebral infarction rates declined significantly in Quebec over 15 years, while intracerebral hemorrhage rates increased. Despite an aging population, stroke case fatality and hospital stays decreased.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke incidence and outcomes are critical public health concerns.
- Understanding temporal trends in stroke subtypes is essential for resource allocation and prevention strategies.
Purpose of the Study:
- To analyze 15-year trends in cerebral infarction and intracerebral hemorrhage rates in Quebec.
- To examine changes in the comorbidity profile and case fatality rates of stroke patients.
- To assess shifts in in-hospital bed stay duration for stroke survivors.
Main Methods:
- A population-based cohort study utilizing hospital discharge data (MedEcho) from 1988 to 2002.
- Inclusion criteria focused on first stroke events, encompassing both cerebral infarction and intracerebral hemorrhage.
- Statistical analysis estimated changes in event rates, case fatality, and hospital stay over the study period.
Main Results:
- Cerebral infarction rates decreased by 32.5% in men and 25.5% in women.
- Intracerebral hemorrhage rates increased by 28% in men and 22% in women.
- Case fatality and in-hospital bed stay significantly declined despite an increase in patient age and comorbidity.
Conclusions:
- Quebec experienced a notable shift from cerebral infarction to intracerebral hemorrhage over 15 years.
- Stroke care improvements led to reduced case fatality and shorter hospitalizations, even with an aging, sicker population.
- These findings highlight evolving stroke epidemiology and the effectiveness of interventions.
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