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Related Experiment Video

Updated: Nov 11, 2025

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Tissue-Based Stroke Definition Impacts Stroke Incidence but not Ethnic Differences.

Lewis B Morgenstern1, Darin B Zahuranec2, Jaewon Lim3

  • 1Stroke Program, Michigan Medicine, Ann Arbor, United States; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, United States; Department of Emergency Medicine, Michigan Medicine, Ann Arbor, United States.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 24, 2021
PubMed
Summary

A new tissue-based stroke definition slightly increased incidence estimates for ischemic stroke and intracerebral hemorrhage (ICH). No ethnic differences were observed between Mexican Americans and non-Hispanic whites in this population-based study.

Keywords:
Diffusion imagingHispanicIncidenceIntracerebral hemorrhageStrokeTissue

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Stroke incidence estimation is crucial for public health planning.
  • The advent of new diagnostic criteria necessitates re-evaluation of existing epidemiological data.
  • Understanding ethnic variations in stroke incidence is vital for targeted health interventions.

Purpose of the Study:

  • To evaluate the impact of a new, tissue-based stroke definition on incidence estimates.
  • To compare stroke incidence between the old and new definitions, with a focus on ethnic disparities.
  • To assess changes in ischemic stroke and intracerebral hemorrhage (ICH) rates.

Main Methods:

  • A population-based study in Nueces County, Texas, from May 2014 to May 2016.
  • Ascertainment and validation of stroke patients using source documentation.
  • Application of ethnic-specific and age-specific Poisson regression models to compare incidence rates between old and new stroke definitions, adjusting for key covariates.

Main Results:

  • The new definition identified 5% more stroke cases.
  • Ischemic stroke incidence showed a modest increase (RR 1.07), with similar trends in Mexican Americans and Non-Hispanic whites.
  • Intracerebral hemorrhage (ICH) incidence increased significantly (RR 1.16), with comparable rises across ethnic groups.

Conclusions:

  • The new tissue-based stroke definition led to modest increases in both ischemic stroke and ICH incidence.
  • No significant ethnic differences in incidence changes were observed between Mexican Americans and Non-Hispanic whites.
  • These updated incidence estimates are valuable for public health planning and resource allocation.