Stroke on the rise in Canada (Research Summary)

A research team from the Heart & Stroke Foundation published a study in December 2022 showing that annual stroke occurrence rates in Canada have increased. They found that approximately every 5 minutes a stroke occurs in Canada (previous estimates were 1 stroke every 9 minutes).

What do we already know?

The total number of stroke events globally has been increasing for decades

• Although stroke rates (# strokes per 100,00 people) are decreasing, the aging population means there is an increasing number of older people at risk for stroke

What is a stroke event?

• The researchers used the definition from the International Classification of Diseases – Canadian 10th iteration (ICD-10-CA)

• Includes: ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack (TIA)

What did they want to know?

They wanted to estimate the number of stroke events that resulted in acute medical attention in the hospital or emergency department in 2017-18 across Canada

What did they do?

Analyzed Canadian health administrative records

Hospital discharge information

• Collected from the Canadian Institute for Health Information (CIHI) Discharge Abstract Database (DAD)
• Only available for Ontario & Alberta, thus ED visits were statistically estimated for other provinces & territories

Emergency department (ED) visit information

• Collected from the CIHI National Ambulatory Care Reporting System (NACRS)

Linked episodes of care to avoid overestimating

• Avoid overestimation of stroke events

Patients may move hospitals or have a minor stroke before having a major stroke

What did they find?

In a 1-year period, (2017-18), there were 108,707 stroke events resulting in hospital or emergency department visits across Canada

Half of these events resulted in hospital admission and the other half resulted in only emergency department presentation (i.e., not admitted to hospital for further care)

This works out to an incidence of 299.4 events per 100,000 people or a stroke event happening every 5 minutes in Canada

Results consistent with other studies estimating stroke incidence in Canada

What does this mean?

Stroke is on the rise in Canada. Looking at both hospital admissions and emergency department visits gives us a more accurate estimate of the occurrence of stroke.

We need ongoing monitoring of stroke incidence and prevalence (i.e., updated estimates based on population health records, like this study did).

Accurate estimates mean we can ensure enough funding and resources are available to provide high-quality care to all stroke survivors and help us evaluate the effectiveness of treatments and prevention efforts (including secondary prevention efforts to prevent recurrent strokes).

Source: Holodinsky, J., Lindsay, P., Yu, A., Ganesh, A., Joundi, R., & Hill, M. (2022). Estimating the number hospital or emergency department presentations for stroke in Canada. Canadian Journal of Neurological Sciences / Journal Canadien Des Sciences Neurologiques, 1-18.
https://doi.org/10.1017/cjn.2022.338

We are starting Knowledge Translation Tuesday, where we summarize a recently published (within the last year) research study to give you current, evidence-based brain injury information.