Trends in stroke hospitalisation rates and in-hospital mortality in Aragon, 1998-2010

Abstract

Introduction: Despite the impact of cerebrovascular disease (CVD) on global health, its morbidity and time trends in Spain are not precisely known.

Objective: The purpose of our study was to characterise the epidemiology and trends pertaining to stroke in Aragon over the period 1998-2010.

Methods: We conducted a retrospective, descriptive study using the data of the Spanish health system's Minimum Data Set and included all stroke patients admitted to acute care hospitals in Aragon between 1 January 1998 and 31 December 2010. We present data globally and broken down by stroke subtype, sex, and age group.

Results: The number of cases increased by 13% whereas age- and sex-adjusted hospitalisation rates showed a significant decrease for all types of stroke (mean annual decrease of 1.6%). Men and women in younger age groups showed opposite trends in hospitalisation rates for ischaemic stroke. Case fatality rate at 28 days (17.9%) was higher in patients with intracerebral haemorrhage (35.8%) than in those with subarachnoid haemorrhage (26.2%) or ischaemic stroke (13%). CVD case fatality showed a mean annual decline of 2.8%, at the expense of the fatality rate of ischaemic stroke, and it was more pronounced in men than in women.

Discussion: Understanding stroke epidemiology and trends at the regional level will help establish an efficient monitoring system and design appropriate strategies for health planning.

Keywords: Cerebrovascular disease; Enfermedad cerebrovascular; Epidemiology; Epidemiología; Hospital-based registry; Hospitalisation rates; In-hospital mortality; Letalidad hospitalaria; Registros hospitalarios; Tasas de hospitalización; Tendencias temporales; Time trends.