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- Kim, Joosup, et al.
(author)
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Global Stroke Statistics 2019
- 2020
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 15:8, s. 819-838
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Research review (peer-reviewed)abstract
- Background: Data on stroke epidemiology and availability of hospital-based stroke services around the world are important for guiding policy decisions and healthcare planning. Aims: To provide the most current incidence, mortality and case–fatality data on stroke and describe current availability of stroke units around the world by country. Methods: We searched multiple databases (based on our existing search strategy) to identify new original manuscripts and review articles published between 1 June 2016 and 31 October 2018 that met the ideal criteria for data on stroke incidence and case–fatality. For data on the availability of hospital-based stroke services, we searched PubMed for all literature published up until 31 June 2018. We further screened reference lists, citation history of manuscripts and gray literature for this information. Mortality codes for International Classification of Diseases-9 and International Classification of Diseases-10 were extracted from the World Health Organization mortality database for each country providing these data. Population denominators were obtained from the World Health Organization, and when these were unavailable within a two-year period of mortality data, population denominators within a two-year period were obtained from the United Nations. Using country-specific population denominators and the most recent years of mortality data available for each country, we calculated both the crude mortality from stroke and mortality adjusted to the World Health Organization world population. Results: Since our last report in 2017, there were two countries with new incidence studies, China (n = 1) and India (n = 2) that met the ideal criteria. New data on case–fatality were found for Estonia and India. The most current mortality data were available for the year 2015 (39 countries), 2016 (43 countries), and 2017 (7 countries). No new data on mortality were available for six countries. Availability of stroke units was noted for 63 countries, and the proportion of patients treated in stroke units was reported for 35/63 countries. Conclusion: Up-to-date data on stroke incidence, case–fatality, and mortality statistics provide evidence of variation among countries and changing magnitudes of burden among high and low–middle income countries. Reporting of hospital-based stroke units remains limited and should be encouraged.
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- Thayabaranathan, Tharshanah, et al.
(author)
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Global stroke statistics 2022
- 2022
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 17:9, s. 946-956
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Research review (peer-reviewed)abstract
- Background: Contemporary data on stroke epidemiology and the availability of national stroke clinical registries are important for providing evidence to improve practice and support policy decisions. Aims: To update the most current incidence, case-fatality, and mortality rates on stroke and identify national stroke clinical registries worldwide. Methods: We searched multiple databases (based on our existing search strategy) to identify new original papers, published between 1 November 2018 and 15 December 2021, that met ideal criteria for data on stroke incidence and case-fatality, and added these to the studies reported in our last review. To identify national stroke clinical registries, we updated our last search, using PubMed, from 6 February 2015 until 6 January 2022. We also screened reference lists of review papers, citation history of papers, and the gray literature. Mortality codes for International Classification of Diseases (ICD)-9 and ICD-10 were extracted from the World Health Organization (WHO) for each country providing these data. Population denominators were obtained from the United Nations (UN) or WHO (when data were unavailable in the UN database). Crude and adjusted stroke mortality rates were calculated using country-specific population denominators, and the most recent years of mortality data available for each country. Results: Since our last report in 2020, there were two countries (Chile and France) with new incidence studies meeting criteria for ideal population-based studies. New data on case-fatality were found for Chile and Kenya. The most current mortality data were available for the year 2014 (1 country), 2015 (2 countries), 2016 (11 countries), 2017 (10 countries), 2018 (19 countries), 2019 (36 countries), and 2020 (29 countries). Four countries (Libya, Solomon Islands, United Arab Emirates, and Lebanon) reported mortality data for the first time. Since our last report on registries in 2017, we identified seven more national stroke clinical registries, predominantly in high-income countries. These newly identified registries yielded limited information. Conclusions: Up-to-date data on stroke incidence, case-fatality, and mortality continue to provide evidence of disparities and the scale of burden in low- and middle-income countries. Although more national stroke clinical registries were identified, information from these newly identified registries was limited. Highlighting data scarcity or even where a country is ranked might help facilitate more research or greater policy attention in this field.
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- Thrift, Amanda G., et al.
(author)
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Global stroke statistics
- 2017
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 12:1, s. 13-32
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Research review (peer-reviewed)abstract
- Background: Up to date data on incidence, mortality, and case-fatality for stroke are important for setting the agenda for prevention and healthcare. Aims and/or hypothesis: We aim to update the most current incidence and mortality data on stroke available by country, and to expand the scope to case-fatality and explore how registry data might be complementary. Methods: Data were compiled using two approaches: (1) an updated literature review building from our previous review and (2) direct acquisition and analysis of stroke events in the World Health Organization (WHO) mortality database for each country providing these data. To assess new and/or updated data on incidence, we searched multiple databases to identify new original papers and review articles that met ideal criteria for stroke incidence studies and were published between 15 May 2013 and 31 May 2016. For data on case-fatality, we searched between 1980 and 31 May 2016. We further screened reference lists and citation history of papers to identify other studies not obtained from these sources. Mortality codes for ICD-8, ICD-9, and ICD-10 were extracted. Using population denominators provided for each country, we calculated both the crude mortality from stroke and mortality adjusted to the WHO world population. We used only the most recent year reported to the WHO for which both population and mortality data were available. Results: Fifty-one countries had data on stroke incidence, some with data over many time periods, and some with data in more than one region. Since our last review, there were new incidence studies from 12 countries, with four meeting pre-determined quality criteria. In these four studies, the incidence of stroke, adjusted to the WHO World standard population, ranged from 76 per 100,000 population per year in Australia (2009–10) up to 119 per 100,000 population per year in New Zealand (2011–12), with the latter being in those aged at least 15 years. Only in Martinique (2011–12) was the incidence of stroke greater in women than men. In countries either lacking or with old data on stroke incidence, eight had national clinical registries of hospital based data. Of the 128 countries reporting mortality data to the WHO, crude mortality was greatest in Kazhakstan (in 2003), Bulgaria, and Greece. Crude mortality and crude incidence of stroke were both positively correlated with the proportion of the population aged ≥ 65 years, but not with time. Data on case-fatality were available in 42 studies in 22 countries, with large variations between regions. Conclusions: In this updated review, we describe the current data on stroke incidence, case-fatality and mortality in different countries, and highlight the growing trend for national clinical registries to provide estimates in lieu of community-based incidence studies.
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- Thrift, Amanda G., et al.
(author)
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Global stroke statistics : An update of mortality data from countries using a broad code of “cerebrovascular diseases”
- 2017
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 12:8, s. 796-801
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Journal article (peer-reviewed)abstract
- Background: Current information on mortality attributed to stroke among different countries is important for policy development and monitoring prevention strategies. Unfortunately, mortality data reported to the World Health Organization by different countries are inconsistent. Aims and/or hypothesis: To update the repository of the most recent country-specific data on mortality from stroke for countries that provide data using a broad code for “cerebrovascular disease.” Methods: Data on mortality from stroke were obtained from the World Health Organization mortality database. We searched for countries that provided data, since 1999, on a combined category of “cerebrovascular disease” (code 1609) that incorporated International Classification of Diseases (10th edition) codes I60–I69. Using population denominators provided by the World Health Organization for the same year when available, or alternatively estimates obtained from the United Nations, we calculated crude mortality from “cerebrovascular disease” and mortality adjusted to the World Health Organization world population. We used the most recent year reported to the World Health Organization, as well as comparing changes over time. Results: Since 1999, seven countries have provided these mortality data. Among these countries, crude mortality was greatest in the Russian Federation (in 2011), Ukraine (2012), and Belarus (2011) and was greater in women than men in these countries. Crude mortality was positively correlated with the proportion of the population aged ≥65 years but not with time. Age-adjusted mortality was greatest in the Russian Federation and Turkmenistan, and greater in men than women. Over time, mortality declined, with the greatest decline per annum evident in Kazakhstan (8.7%) and the Russian Federation (7.0%). Conclusions: Among countries that provided data to the World Health Organization using a broad category of “cerebrovascular disease,” there was a decline in mortality in two of the countries that previously had some of the largest mortality rates for stroke.
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- Cadilhac, Dominique A., et al.
(author)
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Stroke Learning Health Systems : A Topical Narrative Review With Case Examples
- 2023
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In: Stroke. - 0039-2499. ; 54:4, s. 1148-1159
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Research review (peer-reviewed)abstract
- To our knowledge, the adoption of Learning Health System (LHS) concepts or approaches for improving stroke care, patient outcomes, and value have not previously been summarized. This topical review provides a summary of the published evidence about LHSs applied to stroke, and case examples applied to different aspects of stroke care from high and low-to-middle income countries. Our attempt to systematically identify the relevant literature and obtain real-world examples demonstrated the dissemination gaps, the lack of learning and action for many of the related LHS concepts across the continuum of care but also elucidated the opportunity for continued dialogue on how to study and scale LHS advances. In the field of stroke, we found only a few published examples of LHSs and health systems globally implementing some selected LHS concepts, but the term is not common. A major barrier to identifying relevant LHS examples in stroke may be the lack of an agreed taxonomy or terminology for classification. We acknowledge that health service delivery settings that leverage many of the LHS concepts do so operationally and the lessons learned are not shared in peer-reviewed literature. It is likely that this topical review will further stimulate the stroke community to disseminate related activities and use keywords such as learning health system so that the evidence base can be more readily identified.
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