Related Experiment Videos
Stroke rates during the 1980s. The Minnesota Stroke Survey
E Shahar1, P G McGovern, J S Pankow
1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA. shahar@epivax.epi.umn.edu
Background And Purpose:
The decline in stroke mortality it the United States may have resulted from declining incidence improved survival of stroke patients, or both. We previously reported that stroke patients who were 30 to 74 years old and were treated in Minneapolis/St Paul hospitals in 1990 survived longer than did their counterparts in 1980. In the present study, we examined trends in the rate of hospitalized stroke in Minneapolis/ St Paul between 1980 and 1990.
Methods:
For 1980, 1985, and 1990, we obtained lists of discharge codes (International Classification of Diseases, 9th revision) from Minneapolis/St Paul hospitals, identified hospitalizations for acute cerebrovascular disease, and randomly selected 50% of the cases for medical record abstraction. We counted stroke events in five different ways, which were based on discharge codes as well as diagnostic criteria, and computed age adjusted stroke rates for each year. Stroke mortality in the population was computed for 1960 through 1994.
Results:
Among men, all five measures of hospitalized stroke attack rate indicated a decline between 1980 and 1985, which ranged from 5% to > 20%. Among women, there was a sharp contrast between trends that relied on discharge codes and trends that relied on diagnostic criteria: the former indicated a decline (4% to 19%), whereas the latter indicated some increase. For the second half of the 1980s, most measures of stroke attack rate in men, all measures of stroke attack rate in women, and measures of stroke incidence in both sexes did not indicate a decline in stroke occurrence in the population. Mortality from stroke among 30- to 74-year-old residents of Minneapolis/St Paul, which declined rapidly during the 1970s and early 1980s, declined slowly, if at all, during the second half of the 1980s and early 1990s.
Conclusions:
The incidence of stroke may have declined among 30- to 74-year-old residents of Minneapolis/St Paul in the early 1980s. However, we found little indication of such a trend between 1985 and 1990, a period of slow decline or no decline in stroke mortality in that population.
Insights
Stroke incidence declined in Minneapolis/St Paul during the early 1980s, but this trend slowed significantly by the mid-1980s. This study examined hospitalized stroke trends and mortality rates between 1980 and 1990.
Area of Science:
- Epidemiology
- Public Health
- Neurology
Background:
- Stroke mortality in the US may be influenced by incidence and survival rates.
- Previous research indicated improved survival for stroke patients aged 30-74 in Minneapolis/St Paul from 1980 to 1990.
Purpose of the Study:
- To examine trends in hospitalized stroke rates in Minneapolis/St Paul between 1980 and 1990.
- To assess changes in stroke incidence and mortality during this period.
Main Methods:
- Utilized International Classification of Diseases, 9th revision (ICD-9) discharge codes from Minneapolis/St Paul hospitals for 1980, 1985, and 1990.
- Selected 50% of acute cerebrovascular disease cases for medical record abstraction.
- Calculated age-adjusted stroke rates using five different measures and analyzed population stroke mortality from 1960-1994.
Main Results:
- Hospitalized stroke attack rates declined in men (5% to >20%) and women (4% to 19% based on discharge codes) between 1980 and 1985.
- Trends diverged for women: discharge codes showed a decline, while diagnostic criteria indicated an increase.
- From 1985-1990, most measures showed no decline in stroke occurrence for either sex; stroke mortality decline slowed.
Conclusions:
- Stroke incidence may have decreased in 30-74 year olds in Minneapolis/St Paul during the early 1980s.
- Little evidence of declining stroke incidence was found between 1985 and 1990.
- The period of slow or no decline in stroke mortality coincided with the lack of a clear incidence decline.