| Title: |
Trends in stroke incidence, death, and disability outcomes in a multi-ethnic population: Auckland regional community stroke studies (1981–2022) |
| Authors: |
Feigin, Valery L; Krishnamurthi, Rita; Nair, Balakrishnan; Rautalin, Ilari; Parag, Varsha; Anderson, Craig S; Arroll, Bruce; Barber, P Alan; Barker-Collo, Suzanne; Bennett, Derrick; Brown, Paul; Cadilhac, Dominque A; Douwes, Jeroen; Exeter, Daniel; Ranta, Anna; Ratnasabapathy, Yogini; Swain, Andrew; Tautolo, El-Shadan; Te Ao, Braden; Thrift, Amanda; Tunnage, Bronwyn |
| Source: |
The Lancet Regional Health - Western Pacific, vol 56 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2025 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
4206 Public Health (for-2020); 42 Health Sciences (for-2020); Aging (rcdc); Neurosciences (rcdc); Stroke (rcdc); Clinical Research (rcdc); Cerebrovascular (rcdc); Minority Health (rcdc); Brain Disorders (rcdc); Health Disparities (rcdc); 2.4 Surveillance and distribution (hrcs-rac); Stroke (hrcs-hc); Stroke; Trends; Outcomes; Incidence; Mortality; Disability; 3202 Clinical sciences (for-2020); 4203 Health services and systems (for-2020) |
| Description: |
Background: Reliable data on trends of stroke incidence and outcomes over time are necessary for assessing the effectiveness of public health and clinical strategies, and for allocating healthcare resources. We assessed the levels and trends in incidence, mortality, early case fatality and disability for stroke in a defined, ethnically mixed population over 40 years. Methods: To analyse data from five population-based stroke incidence studies in adult residents (age ≥15 years) of the Greater Auckland Region of New Zealand (NZ) (1.35 million) over 12-month calendar periods for 1981-1982, 1991-1992, 2002-2003, 2011-2012, and 2021-2022. Fatal and non-fatal, hospitalised and non-hospitalised stroke events (first-ever and recurrent) were identified through multiple overlapping sources using clinical World Health Organization (WHO) diagnostic criteria and neuroimaging to define three major pathological types of stroke: ischaemic stroke (IS), primary intracerebral haemorrhage (PICH), subarachnoid haemorrhage (SAH), and stroke of undetermined type (SUT). Crude and age-standardised annual incidence, mortality, 28-day case fatality and disability level, and 40-year trends were calculated by age, sex, and ethnicity assuming a Poisson distribution. For comparison of our findings, we carried out a pooled analysis of methodologically comparable population-based stroke epidemiology estimates in high-income countries over the last two decades. Findings: Overall, there were 7462 first-ever strokes (9917 events) over the 40-year period (4,682,012 person-years). From 1981-1982 to 2021-2022, age-standardised stroke incidence rates decreased from 156/100,000 (95% confidence interval [CI] 143; 170) to 124/100,000 (119; 130) and mortality rates from 98/100,000 (88; 110) to 28/100,000 (26; 31) in nearly all age, sex, and ethnic groups. Moreover, from 2002-2003 to 2021-2022, there was an increase in stroke incidence of 1.28% per year (95% CI 0.38-2.17) in people aged 15-54 years, with the mean age of people with stroke decreasing from ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt5h57v5f0; https://escholarship.org/uc/item/5h57v5f0; https://escholarship.org/content/qt5h57v5f0/qt5h57v5f0.pdf |
| DOI: |
10.1016/j.lanwpc.2025.101508 |
| Availability: |
https://escholarship.org/uc/item/5h57v5f0; https://escholarship.org/content/qt5h57v5f0/qt5h57v5f0.pdf; https://doi.org/10.1016/j.lanwpc.2025.101508 |
| Rights: |
public |
| Accession Number: |
edsbas.69BEEF46 |
| Database: |
BASE |