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. 2022 Aug;269(8):4396-4403.
doi: 10.1007/s00415-022-11079-x. Epub 2022 Mar 21.

Time trends in stroke severity in the years 2005 to 2020: results from the Austrian Stroke Unit Registry

Alexandra Bernegger  1 , Dominika Mikšová  2 , Alexandra Posekany  2   3 , Stefan Krebs  1 , Julia Ferrari  1 , Stefan Greisenegger  4 , Thomas Gattringer  5   6 , Wilfried Lang  1   7 , Stefan Kiechl  8   9 , Marek Sykora  10   11 ; Austrian Stroke Unit Registry Collaborators
Collaborators, Affiliations

Time trends in stroke severity in the years 2005 to 2020: results from the Austrian Stroke Unit Registry

Alexandra Bernegger et al. J Neurol. 2022 Aug.

Abstract

Background and purpose: With aging population, there is an increase of atrial fibrillation (AF) and other vascular risk factors. We investigated trends in stroke severity at hospital admission with respect to AF and other risk factors in a prospective national stroke registry from 2005 to 2020.

Methods: Data from the prospective Austrian Stroke Unit Registry were used to study demographic and clinical factors associated with the change in admission stroke severity over years. Time trends in admission stroke severity of patients with pre-stroke modified Rankin Score ≤ 3 were investigated with respect to clinical variables and predefined age groups 18-54, 55-64, 65-74, 75-84 and ≥ 85 years. Time trends were studied using robust generalized linear models assuming normal distribution with a log link. Stroke severity on admission was assessed according to the National Institutes of Health Stroke Scale Score (NIHSS).

Results: In total, 140,312 patients with acute ischemic stroke were included in the analysis. Within the study period, mean patients' age increased from 70 to 72 years (p < 0.001) and median NIHSS at admission decreased from 4 to 3 (p < 0.001). The frequency of AF increased from 25 to 32% (p < 0.001). The decrease in median admission NIHSS was evident in all relevant subgroups but more pronounced in patients with risk factors including AF, diabetes, hypercholesterolemia, smoking, elderly patients and those with pre-stroke disability.

Conclusion: Despite an aging population and generally increasing AF frequency, we observed a consistent trend towards less disabling strokes on admission.

Keywords: Atrial fibrillation; Cerebrovascular disorders; Severity; Stroke; Time trends.

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References

    1. Rothwell PM, Coull AJ, Giles MF, Howard SC, Silver LE, Bull LM et al (2004) Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet 363(9425):1925–1933 - DOI
    1. Lackland DT, Roccella EJ, Deutsch AF, Fornage M, George MG, Howard G et al (2014) Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association. Stroke 45(1):315–353 - DOI
    1. Nezu T, Hosomi N, Lip GY, Aoki S, Shimomura R, Maruyama H et al (2016) Temporal trends in stroke severity and prior antithrombotic use among acute ischemic stroke patients in Japan. Circ J 80(9):2033–2036 - DOI
    1. Koton S, Geva D, Streifler JY, Harnof S, Pougach Y, Azrilin O et al (2018) Declining rate and severity of hospitalized stroke from 2004 to 2013: the National Acute Stroke Israeli Registry. Stroke 49(6):1348–1354 - DOI
    1. Teuschl Y, Brainin M, Matz K, Dachenhausen A, Ferrari J, Seyfang L et al (2013) Time trends in patient characteristics treated on acute stroke-units: results from the Austrian Stroke Unit Registry 2003–2011. Stroke 44(4):1070–1074 - DOI

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