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Incidence and occurrence of total (first-ever and recurrent) stroke.

Publication ,  Journal Article
Williams, GR; Jiang, JG; Matchar, DB; Samsa, GP
Published in: Stroke
December 1999

BACKGROUND AND PURPOSE: It has recently been hypothesized that the figure of approximately half a million strokes substantially underestimates the actual annual stroke burden for the United States. The majority of previously reported studies on the epidemiology of stroke used relatively small and homogeneous population-based stroke registries. This study was designed to estimate the occurrence, incidence, and characteristics of total (first-ever and recurrent) stroke by using a large administrative claims database representative of all 1995 US inpatient discharges. METHODS: We used the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, release 4, which contains approximately 20% of all 1995 US inpatient discharges. Because the accuracy of International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) coding is suboptimal, we performed a literature review of ICD-9-CM 430 to 438 validation studies. The pooled results from the literature review were used to make appropriate adjustments in the analysis to correct for some of the inaccuracies of the diagnostic codes. RESULTS: There were 682 000 occurrences of stroke with hospitalization (95% CI 660 000 to 704 000) and an estimated 68 000 occurrences of stroke without hospitalization. The overall incidence rate for occurrence of total stroke (first-ever and recurrent) was 259 per 100 000 population (age- and sex-adjusted to 1995 US population). Incidence rates increased exponentially with age and were consistently higher for males than for females. CONCLUSIONS: We conservatively estimate that there were 750 000 first-ever or recurrent strokes in the United States during 1995. This new figure emphasizes the importance of preventive measures for a disease that has identifiable and modifiable risk factors and for the development of new and improved treatment strategies and infrastructures that can reduce the consequences of stroke.

Duke Scholars

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Published In

Stroke

DOI

ISSN

0039-2499

Publication Date

December 1999

Volume

30

Issue

12

Start / End Page

2523 / 2528

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Sex Distribution
  • Sensitivity and Specificity
  • Recurrence
  • Prevalence
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Hemorrhages
 

Citation

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Williams, G. R., Jiang, J. G., Matchar, D. B., & Samsa, G. P. (1999). Incidence and occurrence of total (first-ever and recurrent) stroke. Stroke, 30(12), 2523–2528. https://doi.org/10.1161/01.str.30.12.2523
Williams, G. R., J. G. Jiang, D. B. Matchar, and G. P. Samsa. “Incidence and occurrence of total (first-ever and recurrent) stroke.Stroke 30, no. 12 (December 1999): 2523–28. https://doi.org/10.1161/01.str.30.12.2523.
Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and occurrence of total (first-ever and recurrent) stroke. Stroke. 1999 Dec;30(12):2523–8.
Williams, G. R., et al. “Incidence and occurrence of total (first-ever and recurrent) stroke.Stroke, vol. 30, no. 12, Dec. 1999, pp. 2523–28. Pubmed, doi:10.1161/01.str.30.12.2523.
Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and occurrence of total (first-ever and recurrent) stroke. Stroke. 1999 Dec;30(12):2523–2528.

Published In

Stroke

DOI

ISSN

0039-2499

Publication Date

December 1999

Volume

30

Issue

12

Start / End Page

2523 / 2528

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Sex Distribution
  • Sensitivity and Specificity
  • Recurrence
  • Prevalence
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Hemorrhages