Stroke Incidence and Usage Rate of Thrombolysis in A Japanese Urban City: The Kurashiki Stroke Registry

Abstract

To investigate stroke incidence and rate of thrombolytic therapy in an urban city of around 500,000 residents. Patients suffering acute stroke in Kurashiki City (population 474,415) between March 2009 and February 2010 (inclusive) and admitted to 1 of 10 hospitals throughout the city were prospectively enrolled. We enrolled patients with first-ever stroke (n = 763; men 415; median age 72 years) and first-ever/recurrent stroke (n = 1009; men 552; median age 73 years). Among first-ever strokes, 68% were cerebral infarctions, 23% were intracerebral hemorrhages, and 8% were subarachnoid hemorrhages. Crude incidences for first-ever stroke per 100,000 residents were 159.8 (95% confidence interval [CI] 148.4-171.1) for all strokes, 108.8 (95% CI 99.4-118.1) for cerebral infarction, and 36.5 (95% CI 31.0-41.9) for intracerebral hemorrhage. After adjustment using the world population model, age-adjusted incidences were 60.7 (95% CI 45.4-75.9) for all strokes, 38.4 (95% CI 26.3-50.5) for cerebral infarction, and 16.1 (95% CI 8.3-24.0) for intracerebral hemorrhage. Among 698 cases with first-ever and recurrent cerebral infarction, thrombolysis was administered for 31 (5%). Of 197 cerebral infarction patients admitted within 3 hours of onset, the thrombolysis rate was 16%. In this urban Japanese city, the age-adjusted incidence of first-ever stroke between March 2009 and February 2010 was 60.7 per 100,000 residents, which was relatively low compared with findings for other countries. Thrombolysis was given to approximately 5% of patients with acute ischemic stroke.