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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Remarkable decline in ischemic stroke mortality is not matched by changes in incidence
Ilonca Vaartjes1, Martin O'Flaherty, Simon Capewell
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. c.h.vaartjes@umcutrecht.nl
Stroke
|December 6, 2012
Summary
Ischemic stroke (IS) mortality has declined, but IS incidence remains stable or increased. This indicates a rise in nonfatal strokes, highlighting the urgent need for IS prevention strategies to reduce disability and economic burden.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Ischemic stroke (IS) mortality has decreased in Western Europe over decades.
- Understanding age-sex-specific IS mortality, incidence, and fatality is crucial for analyzing recent trends.
Purpose of the Study:
- To analyze trends in ischemic stroke (IS) mortality, incidence, and case fatality in the Netherlands in the new millennium.
- To explain recent changes in IS mortality rates.
Main Methods:
- Utilized nationwide registers for IS deaths (1980-2010) and a cohort of IS patients (1997-2005).
- Employed joinpoint regression and Mann-Kendall tests to analyze trends in mortality, incidence, 30-day case fatality, and 1-year mortality by age and sex.
Main Results:
- IS mortality declined significantly after 2000 across most age-sex groups, with an attenuated decline in the 1990s.
- 30-day case fatality and 1-year mortality improved, but IS incidence remained stable or slightly increased.
- An exception to the mortality decline was observed in young men.
Conclusions:
- The reduction in IS mortality is not mirrored by a decrease in nonfatal IS events.
- The rising burden of nonfatal IS, a leading cause of adult disability, necessitates a strong focus on prevention.
- Urgent IS prevention is critical to mitigate human and economic costs.
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