Objectives

Epidemiological trends for major causes of death and disability, such as stroke, may be monitored using administrative data to guide public health initiatives and service delivery.

Methods

We calculated admissions rates for ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage between 1 January 2005 and December 31^st, 2013 and rates of 30-day mortality and 365-day mortality in 30-day survivors to 31 December 2014 for patients aged 15 years or older from New South Wales, Australia. Annual Average Percentage Change in rates was estimated using negative binomial regression.

Results

Of 81,703 eligible admissions, 64,047 (78.4%) were ischaemic strokes and 13,302 (16.3%) and 4,778 (5.8%) were intracerebral and subarachnoid haemorrhages, respectively. Intracerebral haemorrhage admissions significantly declined by an average of 2.2% annually (95% Confidence Interval = −3.5% to −0.9%) (p < 0.001). Thirty-day mortality rates significantly declined for ischaemic stroke (Average Percentage Change −2.9%, 95% Confidence Interval = −5.2% to −1.0%) (p = 0.004) and subarachnoid haemorrhage (Average Percentage Change = −2.6%, 95% Confidence Interval = −4.8% to −0.2%) (p = 0.04). Mortality at 365-days amongst 30-day survivors of ischaemic stroke and intracerebral haemorrhage was stable over time and increased in subarachnoid haemorrhage (Annual Percentage Change 6.2%, 95% Confidence Interval = −0.1% to 12.8%), although not significantly (p = 0.05).

Discussion

Improved prevention may have underpinned declining intracerebral haemorrhage rates while survival gains suggest that innovations in care are being successfully translated. Mortality in patients surviving the acute period is unchanged and may be increasing for subarachnoid haemorrhage warranting investment in post-discharge care and secondary prevention.

中文翻译：

---

使用大数据的基于人群的中风监测：澳大利亚新南威尔士州全州范围的流行病学趋势，收治和死亡率。

目标

可以使用行政数据来监测主要死亡和残疾原因（例如中风）的流行病学趋势，以指导公共卫生措施和服务提供。

方法

我们计算了2005年1月1日至2013年12月31^日之间的缺血性中风，脑出血和蛛网膜下腔出血的住院率，以及15岁或15岁以上患者至2014年12月31日的30天生存者的30天死亡率和365天死亡率。来自澳大利亚新南威尔士州。利率的年平均百分比变化是使用负二项式回归估算的。

结果

在81,703例合格入院患者中，缺血性中风为64,047例（78.4％），脑内和蛛网膜下腔出血分别为13,302例（16.3％）和4,778例（5.8％）。脑出血的入院人数每年平均显着下降2.2％（95％置信区间= -3.5％至-0.9％）（p <0.001）。缺血性中风的30天死亡率显着下降（平均百分比变化为-2.9％，95％置信区间= -5.2％至-1.0％）（p = 0.004）和蛛网膜下腔出血（平均百分比变化为-2.6％，95％置信区间= -4.8％至-0.2％）（p= 0.04）。缺血性中风和脑出血的30天幸存者中365天的死亡率随时间稳定，蛛网膜下腔出血的发生率增加（年百分比变化6.2％，95％置信区间= −0.1％至12.8％），尽管不显着（p = 0.05）。

讨论区

预防措施的改进可能是导致脑出血率下降的原因，而生存率的提高表明护理方面的创新正在得到成功的转化。急性期幸存者的死亡率没有变化，蛛网膜下腔出血的死亡率可能会增加，因此有必要对出院后护理和二级预防进行投资。