Background and Purpose- Sex differences in stroke incidence over time were previously reported from the GCNKSS (Greater Cincinnati/Northern Kentucky Stroke Study). We aimed to determine whether these differences continued through 2015 and whether they were driven by particular age groups. Methods- Within the GCNKSS population of 1.3 million, incident (first ever) strokes among residents ≥20 years of age were ascertained at all local hospitals during 5 periods: July 1993 to June 1994 and calendar years 1999, 2005, 2010, and 2015. Out-of-hospital cases were sampled. Sex-specific incidence rates per 100 000 were adjusted for age and race and standardized to the 2010 US Census. Trends over time by sex were compared (overall and age stratified). Sex-specific case fatality rates were also reported. Bonferroni corrections were applied for multiple comparisons. Results- Over the 5 study periods, there were 9733 incident strokes (56.3% women). For women, there were 229 (95% CI, 215-242) per 100 000 incident strokes in 1993/1994 and 174 (95% CI, 163-185) in 2015 (P<0.05), compared with 282 (95% CI, 263-301) in 1993/1994 to 211 (95% CI, 198-225) in 2015 (P<0.05) in men. Incidence rates decreased between the first and last study periods in both sexes for IS but not for intracerebral hemorrhage or subarachnoid hemorrhage. Significant decreases in stroke incidence occurred between the first and last study periods for both sexes in the 65- to 84-year age group and men only in the ≥85-year age group; stroke incidence increased for men only in the 20- to 44-year age group. Conclusions- Overall stroke incidence decreased from the early 1990s to 2015 for both sexes. Future studies should continue close surveillance of sex differences in the 20- to 44-year and ≥85-year age groups, and future stroke prevention strategies should target strokes in the young- and middle-age groups, as well as intracerebral hemorrhage.

中文翻译：

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GCNKSS中按性别和年龄划分的卒中发病率随时间变化的时间趋势。

背景和目的-先前通过GCNKSS报告了卒中发生率随时间的性别差异（大辛辛那提/北肯塔基卒中研究）。我们旨在确定这些差异是否持续到2015年，以及是否由特定年龄段造成。方法-在1993年7月至1994年6月以及1999、2005、2010和2015年这5个时期内，在所有当地医院中确定了130万名GCNKSS人口中≥20岁的居民（有史以来）中风。对医院外病例进行了抽样。根据年龄和种族调整了每10万人的性别特定发病率，并根据2010年美国人口普查进行了标准化。比较了按性别划分的时间趋势（总体和年龄分层）。还报告了特定性别的病死率。Bonferroni校正用于多个比较。结果-在5个研究阶段中，发生了9733起中风（女性占56.3％）。女性在1993/1994年每10万笔中风有229（95％CI，215-242）和2015年174（95％CI，163-185）（P <0.05），而282（95％CI） ，在1993/1994年为263-301），到2015年在男性中为211（95％CI，198-225）（P <0.05）。在第一个研究期和最后一个研究期之间，IS的发生率均下降，但脑出血或蛛网膜下腔出血的发生率并未下降。在65至84岁年龄段的男性和仅在≥85岁年龄段的男性中，在第一个研究期和最后一个研究期之间，中风发生率显着降低；仅在20至44岁年龄段的男性中风发生率增加。结论-从1990年代初到2015年，男女总的卒中发生率均下降。未来的研究应继续密切监测20至44岁和≥85岁年龄组的性别差异，未来的中风预防策略应针对年轻和中年组的中风以及脑出血。