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. 2019 Oct 18;116(42):711-717.
doi: 10.3238/arztebl.2019.0711.

The Frequency and Timing of Recurrent Stroke: An Analysis of Routine Health Insurance Data

Jona T Stahmeyer  1 , Sarah Stubenrauch, Siegfried Geyer, Karin Weissenborn, Sveja Eberhard
Affiliations

The Frequency and Timing of Recurrent Stroke: An Analysis of Routine Health Insurance Data

Jona T Stahmeyer et al. Dtsch Arztebl Int. .

Abstract

Background: Stroke is among the leading causes of death in Germany and one of the main reasons for handicap and disability. The risk factors for stroke include hypertension, metabolic disorders, and diabetes. An estimated 250 000 persons sustain a stroke in Germany each year. German data on the occurrence of stroke, and of recurrent stroke in particular, are still inadequate. The main objective of this study was to determine the frequency and timing of recurrent stroke.

Methods: The analyses were based on routine data of the AOK statutory health insurance fund in the German federal state of Lower Saxony. Inpatient billing and diagnosis data were used to identify initial and recurrent strokes (ICD-10 I60-I64). The derived incidence and prevalence were standardized for age and sex. The risks of recurrence and mortality were estimated with Kaplan-Meier analyses and Cox regressions.

Results: In 2010/2011, the standardized incidence of stroke was 292 per 100 000 persons per year, and the standardized prevalence was 336 per 100 000 persons. The risk of recurrence was 1.2% in the first 30 days, 3.4% within 90 days, 7.4% within 1 year, and 19.4% within 5 years. The mortality after an initial stroke was 6.8% in the first 30 days, 9.4% within 90 days, 17.0% within 1 year, and 45% within 5 years. Patients with hemorrhagic strokes had higher mortality. Treatment in a stroke unit was associated with lower mortality.

Conclusion: Patients with acute stroke should be treated in a specialized center whenever possible. After hospital discharge, stroke patients should be followed up at short intervals and any risk factors for stroke should be treated.

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Figures

Figure 1
Figure 1
Flow chart of data processing and analysis The figure shows processing steps and numbers of insurance scheme members with a stroke diagnosis who were included in the respective analyses.
Figure 2
Figure 2
Recurrence rate Proportion of insurance scheme members with a stroke recurrence in the follow-up period (x-axis: time in days, y-axis: number of insurance scheme members)
Figure 3
Figure 3
Mortality after incident stroke event Proportion of surviving insurance scheme members after incident stroke in the follow-up period (x-axis: time in days, y-axis: proportion of insurance scheme members)
See this image and copyright information in PMC

Comment in

  • Supplementary Methodological and Clinical Aspects.
    Eyding J, Bartig D, Weber R, Hacke W, Krogias C. Eyding J, et al. Dtsch Arztebl Int. 2020 Mar 20;117(12):211. doi: 10.3238/arztebl.2020.0211a. Dtsch Arztebl Int. 2020. PMID: 32343655 Free PMC article. No abstract available.

References

    1. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–1210. - PMC - PubMed
    1. Busch MA, Kuhnert R. 12-Monats-Prävalenz von Schlaganfall oder chronischen Beschwerden infolge eines Schlaganfalls in Deutschland. J Health Monit. 2017;2:70–76.
    1. Kohler M, Deutschbein J, Peschke D, Schenk L. [Stroke occurrence in Germany—on the comparability of insurance data and registry-based data] Fortschr Neurol Psychiatr. 2014;82:627–633. - PubMed
    1. Nimptsch U, Mansky T. Trends in acute inpatient stroke care in Germany—an observational study using administrative hospital data from 2005-2010. Dtsch Arztebl Int. 2012;109:885–892. - PMC - PubMed
    1. Busch MA, Schienkiewitz A, Nowossadeck E, Gößwald A. [Prevalence of stroke in adults aged 40 to 79 years in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)] Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:656–660. - PubMed