TY - JOUR
T1 - Time trends in stroke severity in the years 2005 to 2020
T2 - results from the Austrian Stroke Unit Registry
AU - Austrian Stroke Unit Registry Collaborators
AU - Bernegger, Alexandra
AU - Mikšová, Dominika
AU - Posekany, Alexandra
AU - Krebs, Stefan
AU - Ferrari, Julia
AU - Greisenegger, Stefan
AU - Gattringer, Thomas
AU - Lang, Wilfried
AU - Kiechl, Stefan
AU - Sykora, Marek
AU - Tinchon, Alexander
AU - Oberndorfer, Stephan
AU - Gatterer, Andreas
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2022/8
Y1 - 2022/8
N2 - Background and purpose: With aging population, there is an increase of atrial fibrillation (AF) and other vascular risk factors. We investigated trends in stroke severity at hospital admission with respect to AF and other risk factors in a prospective national stroke registry from 2005 to 2020. Methods: Data from the prospective Austrian Stroke Unit Registry were used to study demographic and clinical factors associated with the change in admission stroke severity over years. Time trends in admission stroke severity of patients with pre-stroke modified Rankin Score ≤ 3 were investigated with respect to clinical variables and predefined age groups 18–54, 55–64, 65–74, 75–84 and ≥ 85 years. Time trends were studied using robust generalized linear models assuming normal distribution with a log link. Stroke severity on admission was assessed according to the National Institutes of Health Stroke Scale Score (NIHSS). Results: In total, 140,312 patients with acute ischemic stroke were included in the analysis. Within the study period, mean patients’ age increased from 70 to 72 years (p < 0.001) and median NIHSS at admission decreased from 4 to 3 (p < 0.001). The frequency of AF increased from 25 to 32% (p < 0.001). The decrease in median admission NIHSS was evident in all relevant subgroups but more pronounced in patients with risk factors including AF, diabetes, hypercholesterolemia, smoking, elderly patients and those with pre-stroke disability. Conclusion: Despite an aging population and generally increasing AF frequency, we observed a consistent trend towards less disabling strokes on admission.
AB - Background and purpose: With aging population, there is an increase of atrial fibrillation (AF) and other vascular risk factors. We investigated trends in stroke severity at hospital admission with respect to AF and other risk factors in a prospective national stroke registry from 2005 to 2020. Methods: Data from the prospective Austrian Stroke Unit Registry were used to study demographic and clinical factors associated with the change in admission stroke severity over years. Time trends in admission stroke severity of patients with pre-stroke modified Rankin Score ≤ 3 were investigated with respect to clinical variables and predefined age groups 18–54, 55–64, 65–74, 75–84 and ≥ 85 years. Time trends were studied using robust generalized linear models assuming normal distribution with a log link. Stroke severity on admission was assessed according to the National Institutes of Health Stroke Scale Score (NIHSS). Results: In total, 140,312 patients with acute ischemic stroke were included in the analysis. Within the study period, mean patients’ age increased from 70 to 72 years (p < 0.001) and median NIHSS at admission decreased from 4 to 3 (p < 0.001). The frequency of AF increased from 25 to 32% (p < 0.001). The decrease in median admission NIHSS was evident in all relevant subgroups but more pronounced in patients with risk factors including AF, diabetes, hypercholesterolemia, smoking, elderly patients and those with pre-stroke disability. Conclusion: Despite an aging population and generally increasing AF frequency, we observed a consistent trend towards less disabling strokes on admission.
KW - Aged
KW - Aged, 80 and over
KW - Atrial Fibrillation/complications
KW - Austria/epidemiology
KW - Brain Ischemia/complications
KW - Humans
KW - Ischemic Stroke
KW - Prospective Studies
KW - Registries
KW - Risk Factors
KW - Severity of Illness Index
KW - Stroke/etiology
KW - Stroke
KW - Atrial fibrillation
KW - Severity
KW - Cerebrovascular disorders
KW - Time trends
UR - http://www.scopus.com/inward/record.url?scp=85133331671&partnerID=8YFLogxK
U2 - 10.1007/s00415-022-11079-x
DO - 10.1007/s00415-022-11079-x
M3 - Journal article
C2 - 35307755
SN - 0340-5354
VL - 269
SP - 4396
EP - 4403
JO - Journal of Neurology
JF - Journal of Neurology
IS - 8
ER -