Trends Of Stroke In Shanghai

Stroke is one of the leading causes of adult death and disability in China. It has recently been predicted that there would be more and more strokes occurred in the next decade if no more actions were taken. The aim of this study was to describe and analyze the trends and characters of stroke in Shanghai using the surveillance system.We select all the stroke cases occurred in the period 2000-2008 using the surveillance system (n=37646).With the method of epidemiological analysis (retrospective research), we count the incidence rate and mortality rate of stroke, standardized by the world standard population, during 2005-2008, and analyze the differences of the stroke cases by gender, age, occupation, predisposing factors, disease time, death time and etc.During 2000-2008, totally 37646 stroke cases were collected in the surveillance system with the loss to follow-up rate 1.7%.Among these cases,49.2% male and 50.8% female are emcompassed. The 2005-2008 Shanghai population age standardized total stroke incidence rate for all surveillance population was 132 per 100,000,117 per 100,000,94 per 100,000 and 83 per 100,000, respectively. The standardized mortality rate was 66 per 100,000,63 per 100,000,58 per 100,000 and 52 per 100,000, respectively. During the same period, the crude incidence rate for male was 244 per 100,000,235 per 100,000,195 per 100,000,173 per 100,000, respectively and for female was 243 per 100,000 (p-value=0.845,compared with male and female in the same year),234 per 100,000 (p-value=0.881),191 per 100,000 (p-value=0.426),177 per 100,000(p-value=0.437),respectively. The crude mortality rate for male was 125 per 100,000,126 per 100,000,120 per 100,000,113 per 100,000, respectively and for female was 132 per 100,000 (p-value=0.205),139 per 100,000 (p-value=0.001),135 per 100,000 (p-value<0.001),122 per 100,000 (p-value=0.016) respectively. The average age of all stroke incidence cases was 73.39±0.12 years old (male=71.62±0.17yr. old, female=75.11±0.15yr. old, p-value<0.001) and mortality cases was 77.96±0.16 years (male=75.88±0.25, female=79.84±0.19, p-value<0.001). Among the known predisposing factors of stroke, improper physical activities and fatigue contributed to the majorities.The former accouted for 39.8% and the latter accouted for 29.4%. The fatality rate of stroke was 32.4%(male=31.4%, female=33.4%, p-value<0.001) and the survial time of stroke was 19 days (male=13d, female=19d, p-value<0.001). The fatality rate of the old people (age≥60yr. old) was 32.4%,the other (age<60 yr. old) was 21.6% (p-value<0.001). The fatality rate of initial stroke and recurrent stroke (1 time,2 times) was 35.1%,52.3%(initial vs. recurrent for 1 time, p-value<0.001),48.2%(initial vs. recurrent for 2 times, p-value<0.001, recurrent for 1 time vs. recurrent for 2 times, p-value=0.092), respectively. The fatality rate of cerebral infarction (CI), intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) was 22.5%,51.0%(CI vs. ICH, p-value<0.001) and 50.7%(CI vs. SAH, p-value<0.001, ICH vs. SAH, p-value=0.471), respectively.Although the declining tendency of stroke incidence and mortality rate has been shown recent 3-4years for the effective preventive measures, compared with the simultaneous rates of developed countries, there is still a long way to go. Although the male and female incidence rate of stroke show no significance, the male mortality rate is significantly lower than the female.The male average age of stroke onset 3.49 years earlier than the female and the death age is 3.96 years earlier. Improper physical activities and fatigue contributed to the majorities of the known possible predisposing factors of stroke which are quite hidden and complicated. The fatality rate of stroke was as follows:male lower than female (but the survival time is on the contrary), the young lower than the old, the initial lower than the recurrent, the ischemic stroke lower than the hemorrhagic stroke.