Current trends in stroke events, mortality, and case fatality in Switzerland: an epidemiologic update

瑞士卒中事件、死亡率和病死率的最新趋势:流行病学更新

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Abstract

BACKGROUND: Stroke is a major cardiovascular disease. The last epidemiologic update of stroke events, mortality, and case fatalities (CF) in Switzerland was performed in 2004. Between 2004 and 2017, traditional- and non-traditional cardiovascular risk factors changed, life expectancy increased, stroke units were implemented, and stroke treatment standardized. Therefore, we present an update of Swiss stroke epidemiology. METHODS: Data were obtained from two databases, the Federal Hospital Discharge Statistics (HOST, n = 1 470 259) and the Cause of Death (CoD) database (n = 66 971), to analyze stroke diagnoses coded according to I60-I64 (ICD 10) in 2017 in Switzerland. Discharge- and event rates for stroke, in- and out-of-hospital CF, and mortality were calculated. RESULTS: In 2017, there were 26 032 stroke discharges in Switzerland (45% women) compared to 13 996 discharges in 2004. The age-standardized event rate per 100 000 increased in women/men from 119.7/178.7 in 2004 to 265.1/396.7 in 2017. However, the absolute number of stroke deaths decreased between 2004 and 2017 from 3569 (60% women) to 2816 (59% women). The overall sex-stratified mortality rate approximately halved between 2004 and 2017 in women (from 77.5 to 38.5/100 000) and men (from 56.1 to 27.2/100 000). The overall CF halved between 2004 and 2017 from 22.7% to 10.5% and was higher in women (13.4%) compared to men (8.0%). CONCLUSIONS: Compared to 2004, the rates of stroke events and discharges have increased in Switzerland. However, the overall CF rate and overall sex-stratified mortality rate has approximately halved. This suggests, among other factors, increased recognition and better treatments for stroke.

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