Time trends in hospital-referred stroke and transient ischemic attack: results of a 7-year nationwide survey in France.
BACKGROUND
Nationwide evaluations of the burden of stroke are scarce. We aimed to evaluate trends in stroke and transient ischemic attack (TIA) hospitalization, in-hospital case fatality rates (CFRs) and mortality rates in France during 2000-2006.


METHODS
Hospitalizations for stroke and TIA were determined from National Hospital Discharge Diagnosis Records that used the International Classification of Disease, 10th revision, codes I60, I61, I63, I64, G45, G46. CFRs and mortality rates were estimated from the national death certificates database.


RESULTS
The total number of stays for stroke increased between 2000 and 2006 (88,371 vs. 92,118) contrasting with a decrease in that for TIA. The age-standardized (European population) hospitalization rates for TIA decreased in men (52.2 vs. 44.5/100,000/year, p = 0.002), whereas they remained stable in women (32.4 vs. 31.0/ 100,000/year). Concerning stroke, a decrease in hospitalization rates was observed in both men (from 135.3 to 123.4/ 100,000/year, p < 0.001) and women (from 85.1 to 80.7, p < 0.001). Whatever the age group and the sex, a sharp decrease in in-hospital stroke CFRs was noted. In addition, a 23% decrease in mortality rates was observed. This decrease was greater in patients >65 years.


CONCLUSIONS
Our results demonstrate a decline in hospitalization rates for stroke, and in both stroke CFRs and mortality rates between 2000 and 2006. Improvements in stroke prevention and acute stroke care may have contributed to these results, and may have been initiated by recent advances in health policy with regard to this disease in France.
Béjot
Yannick
Y
Dijon Stroke Registry, University Hospital and Faculty of Medicine of Dijon, University of Burgundy, 3 Rue du Faubourg Raines, Dijon, France. ybejot@yahoo.fr
Aouba
Albertine
A
de Peretti
Christine
C
Grimaud
Olivier
O
Aboa-Eboulé
Corine
C
Chin
Francis
F
Woimant
France
F
Jougla
Eric
E
Giroud
Maurice
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006306:Health Surveys; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D007902:Length of Stay / Q000639:trends; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator