title: Trends in stroke hospitalisation rates in Extremadura between 2002 and 2014: Changing the notion of stroke as a disease of the elderly.
abstract: BACKGROUND
  The incidence of stroke in Spain has been evaluated in several studies, whose results are highly variable and not comparable. No studies of stroke have analysed epidemiological changes in younger patients.
  
  
  METHODS
  We conducted a retrospective observational study using the Spanish health system's Minimum Data Set and included all patients older than 19 hospitalised due to stroke (ICD-9-CM codes 434.01, 434.11, 434.91, 430, 431, 432.9, 436, and 435) between 2002 and 2013. The analysis was performed using joinpoint regression.
  
  
  RESULTS
  A total of 39,321 patients were identified (47.25% were women); 3.73% were aged 20-44, 6.29% were 45-54, 11.49% were 55-64, 23.89% were 65-74, and 54.60% were > 74 years. The hospitalisation rate due to ischaemic stroke has increased significantly in men aged 45-54 (+6.7%; 95% CI, 3.3-10.2) and in women aged 20-44 and 45-54 (+6.1%; 95% CI, 0.8-11.7 and +5.7%; 95% CI, 3.0-8.4, respectively). We also observed a significant increase in the rate of hospitalisation due to ischaemic stroke in men aged over 74 (+4.2%; 95% CI, 1.3-7.2). The rate of hospitalisations due to transient ischaemic attack has also increased significantly whereas the rate of hospitalisations due to brain haemorrhage has stabilised over time.
  
  
  CONCLUSIONS
  Our results provide indirect evidence that the epidemiological profile of stroke is changing based on the increase in hospitalisation rates in young adults.
authors: Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España; Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad de Extremadura, Badajoz, España. Electronic address: j.ramrez@gmail.com.
authors: J M
authors: JM
authors: Ramírez-Moreno
authors: Centro de Salud Villanueva Norte, Villanueva de la Serena, Badajoz, España; Unidad de Investigación Área sanitaria de Don Benito-Villanueva, Grupo GRIMEX, Badajoz, España.
authors: F J
authors: FJ
authors: Felix-Redondo
authors: Unidad de Investigación Área sanitaria de Don Benito-Villanueva, Grupo GRIMEX, Badajoz, España.
authors: D
authors: D
authors: Fernández-Bergés
authors: Subdirección de Sistemas de Información, Servicio Extremeño de Salud, Mérida, Badajoz, España.
authors: L
authors: L
authors: Lozano-Mera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult
keywords: Cerebrovascular disease; Clasificación Internacional de Enfermedades; Enfermedad cerebrovascular; Epidemiology; Epidemiología; Hospitalisation rates; Ictus; Incidence; Incidencia; International Classification of Diseases; Stroke; Tasas de hospitalización