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. 2022 Mar 17;11(6):1669.
doi: 10.3390/jcm11061669.

Patients Hospitalized for Ischemic Stroke and Intracerebral Hemorrhage in France: Time Trends (2008-2019), In-Hospital Outcomes, Age and Sex Differences

Valérie Olié  1 , Clémence Grave  1 , Philippe Tuppin  2 , Gauthier Duloquin  3 , Yannick Béjot  3 , Amélie Gabet  1
Affiliations

Patients Hospitalized for Ischemic Stroke and Intracerebral Hemorrhage in France: Time Trends (2008-2019), In-Hospital Outcomes, Age and Sex Differences

Valérie Olié et al. J Clin Med. .

Abstract

Background: Rates of patients hospitalized for stroke increased among people aged under 65 years in France, as has been found in other countries.

Methods: To analyze time trends in the rates of patients hospitalized for ischemic stroke (IS) and intracerebral hemorrhage (ICH) in France between 2008 and 2019 and determine related short-term outcomes mainly, we selected all patients hospitalized for stroke using the French national hospital database.

Results: The average annual percentage change in the rates of patients hospitalized for IS increased significantly in men and women aged 50-64 years (+2.0%) and in men aged 18-34 years (+1.5%) and 35-44 years (+2.2%). A decrease in the average annual percentage change was observed for IS among people aged over 75 years and among those over 50 years for ICH. After adjustment on confounding factors, women were less likely to die in hospital. Case fatality rates decreased overtime in all age groups for both sexes, with a more pronounced decrease for IS than ICH.

Conclusions: The increasing trend of IS among adults under 65 years is ongoing, highlighting the urgent need for stroke prevention programs in that age. For the first time, we recorded a decrease in the rates of patients hospitalized for ICH among the population over 50 years.

Keywords: hospitalization; intracerebral hemorrhage; ischemic stroke; outcomes; temporal trends.

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Conflict of interest statement

Yannick Béjot declared having received consulting fees from NovoNordisk and payment or honoraria from BMS, Pfizer, Medtronic, Amgen, Boehringer-Ingelheim, and Servier outside the submitted work. The other authors declared no conflict of interest with the presented work.

Figures

Figure 1
Figure 1
Time trends in age-standardized † rates of patients hospitalized for ischemic stroke (IS) and intracerebral hemorrhage (ICH) between 2008 and 2019 in France according to sex and age group. (A) Among inhabitants under 65 years. (B) Among inhabitants over 65 years. Gray: men; black: women. * p-value for trend < 0.05. † Rates standardized on the age structure of the 2010 European population census.
Figure 2
Figure 2
Average annual time trends † in rates and numbers of patients hospitalized for ischemic stroke (IS) and intracerebral hemorrhage (ICH) between 2008 and 2019 in France according to sex and age group. (A) Average annual percentage change in the rates of patients hospitalized for stroke. (B) Average annual percentage change in the absolute number of patients hospitalized for stroke. † Only significant average annual percentage changes are reported in the figure.
Figure 3
Figure 3
Time trends in the rates of thrombolysis and mechanical thrombectomy (MT) in patients hospitalized for ischemic strokes from 2012 to 2019. Note: Thrombolysis data have only been available since 2012; MT has only been referenced as a medical procedure since August 2017.
Figure 4
Figure 4
Time trends in the in-hospital case fatality rates (%) for ischemic stroke (IS) and intracerebral hemorrhage (ICH) in France according to sex and age group. Gray: men; black: women.
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