Dynamics of Stroke Incidence and Mortality Indicators over Eight-Year Period in the Territories Included into the Federal Program of Reorganization of Care for Patients with Stroke

Background. Stroke is a severe medical, social and economic burden for all countries of the world. The leading indicators characterizing the “epidemiological picture” of stroke are the incidence and mortality rates from stroke.

Aims. Analyze the dynamics of stroke incidence and mortality rates in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke for the period from 2009 to 2016.

Material and methods. The study was based on the data of the territorial-population register for seven study areas in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke (Republic of Bashkortostan, Sverdlovsk region, Republic of Tatarstan, Sakhalin region, Stavropol Territory, Ivanovo Region and Irkutsk Region). The age of the examined persons was 25 years and older.

Results. In the period from 2009 to 2016, in the studied territories, there was a consistent stable decrease in the value of the stroke incidence rate. Stroke mortality rates fluctuated with a single increase in 2012. When comparing the average incidence of stroke and mortality from it between 2009 and 2016, we discovered a statistically significant decrease in the incidence of stroke – by 1.4 times and in the rate of mortality from stroke – by 2.3 times. According to the results of the cluster analysis, we revealed a significant conformity (similarity) of mortality rates between regions by 2016 and the absence of monotony (stability) of the rate of stroke incidence.

Conclusion. In all the regions under study, an almost systematic annual decrease in the incidence and mortality rates from stroke among the adult population was revealed in seven studied territories. The results of cluster analysis of the “picture” of stroke incidence and mortality from it also demonstrate a positive trend by 2016 in all studied territories. Only one of the studied territories – the Republic of Tatarstan – despite the presence of a positive dynamics of stroke incidence over an eight-year period, in 2016 belonged to the rank with a high integral incidence rate.

1. Rajsic S, Gothe H, Borba HH, Sroczynski G, Vujicic J, Toell T, et al. Economic burden of stroke: A systematic review on poststroke care. Eur J Health Econ. 2019; 20(1): 107-134. doi: 10.1007/s10198-018-0984-0

2. Doria JW, Forgacs PB. Incidence, implications, and management of seizures following ischemic and hemorrhagic stroke. Curr Neurol Neurosci Rep. 2019; 19(7): 37. doi: 10.1007/s11910-019-0957-4

3. Starodubtseva OS, Begicheva SV, Shirokov VA, Osinkin GA. Chronopathological aspects of stroke epidemiology in an industrial city. Ural Medical Journal. 2017; (1): 21-25. (In Russ.)

4. Gafarova AV, Gromova EA, Panov DO, Gagulin IV, Krymov EA, Gafarov VV. Social support and stroke risk: An epidemiological study of a population aged 25-64 years in Russia/Siberia (the WHO MONICA-psychosocial program). Neurology, Neuropsychiatry, Psychosomatics. 2019; 11(1): 12-20. doi: 10.14412/2074-2711-20191-12-20. (In Russ.)

5. Aigner A, Grittner U, Rolfs A, Norrving B, Siegerink B, Busch MA. Contribution of established stroke risk factors to the burden of stroke in young adults. Stroke. 2017; 48(7): 1744-1751. doi: 10.1161/STROKEAHA.117.016599

6. Kurepina IS, Zorin RA, Zhadnov VA, Sorokin OA. Hemorrhagic stroke: neurophysiological predictors of the acute period. Acta biomedica scientifica. 2020; 5(5): 47-52. doi: 10.29413/ABS.2020-5.5.6. (In Russ.)

7. Mirbabaeva NN, Belopasov VV. Prophylaxis and treatment of stress affective disorders at ischemic stroke. Astrakhan Medical Journal. 2016; 11(1): 89-95. (In Russ.)

8. Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: A meta-analysis and systematic review. JAMA. 2011; 306(11): 1241-1249. doi: 10.1001/jama.2011.1282

9. Feigin VL, Howard G. The importance of epidemiological studies should not be downplayed. Stroke. 2008; 39(1): 1-2. doi: 10.1161/STROKEAHA.107.503250

10. Kharakoz OS, Kanorsky SG, Shchelchkova I, Kizhvatova NV. The first results of the stroke register in Krasnodar. S.S. Korsakov Journal of Neurology and Psychiatry. 2001; 101(2): 26-30. (In Russ.)

11. Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D, et al. Global, regional, and national burden of stroke, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18(5): 439-458. doi: 10.1016/S1474-4422(19)30034-1

12. Donkor ES. Stroke in the 21st century: A snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat. 2018; 2018: 3238165. doi: 10.1155/2018/3238165

13. Lackland DT, Roccella EJ, Deutsch AF, Fornage M, George MG, Howard G, et al. Factors influencing the decline in stroke mortality: A statement from the American Heart Association/American Stroke Association. Stroke. 2014; 45(1): 315-353. doi: 10.1161/01.str.0000437068.30550.cf