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Type: Journal article
Title: Adelaide Stroke Incidence Study: declining stroke rates but many preventable cardioembolic strokes
Author: Leyden, J.
Kleinig, T.
Newbury, J.
Castle, S.
Cranefield, J.
Anderson, C.
Crotty, M.
Whitford, D.
Jannes, J.
Lee, A.
Greenhill, J.
Citation: Stroke, 2013; 44(5):1226-1231
Publisher: Lippincott Williams & Wilkins
Issue Date: 2013
ISSN: 0039-2499
Statement of
James M. Leyden, Timothy J. Kleinig, Jonathan Newbury, Sally Castle, Jennifer Cranefield, Craig S. Anderson, Maria Crotty, Deirdre Whitford, Jim Jannes, Andrew Lee, Jennene Greenhill
Abstract: <h4>Background and purpose</h4>Stroke incidence rates are in flux worldwide because of evolving risk factor prevalence, risk factor control, and population aging. Adelaide Stroke Incidence Study was performed to determine the incidence of strokes and stroke subtypes in a relatively elderly population of 148 000 people in the Western suburbs of Adelaide.<h4>Methods</h4>All suspected strokes were identified and assessed in a 12-month period from 2009 to 2010. Standard definitions for stroke and stroke fatality were used. Ischemic stroke pathogenesis was classified by the Trial of ORG 10172 in Acute Stroke Treatment criteria.<h4>Results</h4>There were 318 stroke events recorded in 301 individuals; 238 (75%) were first-in-lifetime events. Crude incidence rates for first-ever strokes were 161 per 100 000 per year overall (95% confidence interval [CI], 141-183), 176 for men (95% CI, 147-201), and 146 for women (95% CI, 120-176). Adjusted to the world population rates were 76 overall (95% CI, 59-94), 91 for men (95% CI, 73-112), and 61 for women (95% CI, 47-78). The 28-day case fatality rate for first-ever stroke was 19% (95% CI, 14-24); the majority were ischemic (84% [95% CI, 78-88]). Intracerebral hemorrhage comprised 11% (8-16), subarachnoid hemorrhage 3% (1-6), and 3% (1-6) were undetermined. Of the 258 ischemic strokes, 42% (95% CI, 36-49) were of cardioembolic pathogenesis. Atrial fibrillation accounted for 36% of all ischemic strokes, of which 85% were inadequately anticoagulated.<h4>Conclusions</h4>Stroke incidence in Adelaide has not increased compared with previous Australian studies, despite the aging population. Cardioembolic strokes are becoming a higher proportion of all ischemic strokes.
Keywords: acute cerebral hemorrhage
acute cerebral infarction
acute stroke syndromes
Rights: © 2013 American Heart Association, Inc.
DOI: 10.1161/STROKEAHA.113.675140
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