title: Epidemiologic Trends in Hospitalized Ischemic Stroke from 2002 to 2010: Results from a Large Italian Population-Based Study.
abstract: BACKGROUND
  To describe the incidence of ischemic stroke, short-term mortality, recurrences, and prescription patterns.
  
  
  METHODS
  Data from administrative health databases of the Lombardy Region from 2002 to 2010 (about 4 million people) were analyzed for stroke incidence and recurrence, mortality, and drug prescriptions after an ischemic stroke.
  
  
  RESULTS
  A total of 43,352 patients with a first hospital admission for ischemic stroke were identified. During 8 years, stroke incidence decreased from 3.2 of 1000 to 2.4 of 1000 (P < .001) in people aged 65-74 years, from 7.1 of 1000 to 5.3 of 1000 (P < .001) at ages 75-84 years and from 11.9 of 1000 to 9.4 of 1000 (P < .001) at age 85 years or older. Stroke recurrences dropped by 30% (from 10.0% to 7.0%, P < .001) and 30-day mortality rate also decreased. Prescription trends showed linear increase in antiplatelets and lipid-lowering drugs, respectively, from 60.2% to 65.0% (P < .001) and from 19.1% to 34.6% (P < .001), whereas antihypertensive prescriptions did not change appreciably. Anticoagulant prescription increased in patients with atrial fibrillation, from 64.8% to 72.1% in the 65-74 years age group, (P = .004) and from 40.2% to 53.7% in the 75-84 years age group (P < .001); less than 20% of the 85 years or older age group were treated with anticoagulants (P < .0001).
  
  
  CONCLUSIONS
  Stroke incidence, recurrence, and 30-day mortality decreased from 2002 to 2010 concomitant with an increase in prescriptions of secondary stroke prevention drugs.
authors.affiliation: Laboratory for Quality Assessment of Geriatric Therapies and Services, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy; Scientific Direction and Emergency Medicine Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: paola.santalucia@marionegri.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Santalucia
authors.affiliation: Laboratory of General Practice Research, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Baviera
authors.affiliation: Laboratory of General Practice Research, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cortesi
authors.affiliation: Laboratory of Geriatric Neuropsychiatry, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.affiliation: Laboratory of General Practice Research, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Marzona
authors.affiliation: Laboratory for Quality Assessment of Geriatric Therapies and Services, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
authors.affiliation: Laboratory of Geriatric Neuropsychiatry, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Riva
authors.affiliation: Regional Health Ministry, Milan, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.affiliation: Regional Health Ministry, Milan, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.affiliation: Regional Health Ministry, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.affiliation: Laboratory of General Practice Research, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Roncaglioni
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D018672:Community Health Planning; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D055553:Prescription Drugs / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality
chemical_list: D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D055553:Prescription Drugs
keywords: Stroke incidence; administrative database; mortality; recurrences; secondary stroke prevention