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stroke

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Epidemiology of Stroke
Dexter L. Morris, PhD, MD
Department of Emergency Medicine
University of North Carolina School of Medicine
Chapel Hill, NC
Stroke Incidence and Prevalence
• 600,000 new strokes each year
• 160,000 deaths
• US: 83% of strokes ischemic, 17%
hemorrhagic
Dexter L. Morris, PhD, MD
Age-Adjusted Stroke Mortality Rates in the United
States from 1979 to 1998 by Race and Gender
80
70
60
Black Men
Black Women
White Men*
White Women
Total US
50
40
30
20
10
79
19
81
83
85
87
89
Year
91
93
95
97
Dexter L. Morris, PhD, MD
Death rates of each HSA compared to U.S. rate (1988-92)
Stroke- White Male
Dexter L. Morris, PhD, MD
Total Deaths from Stroke in the United
States by Year,1979-1998
45
165
40
160
35
155
30
150
25
145
20
140
15
135
130
10
125
5
120
0
1979
80
81
82
83
84
85
86
87
88
89
Year
90
91
92
93
94
95
Dexter L. Morris, PhD, MD
96
97
98
Total age-adjusted stroke mortality rate/100,000
170
Stroke deaths in thousands
Total Stroke Deaths in the United States by
Race and Age, 1998
White Men
Black Men
Other Men
60
6%
White Women
Black Women
Other Women
1% 1%
5%
50
34%
40
30
20
53%
Total Deaths
10
0
<44
45-54
55-64
Age group
65-74
75-84
Dexter L. Morris, PhD, MD
>85
Risk Factors For Stroke
•
•
•
•
•
•
•
Hypertension
Previous Stroke/TIA
Heart Disease
Atrial Fibrillation
Carotid Bruit
Diabetes
Smoking
•
•
•
•
Older > Younger
Black > Hispanic
Hispanic > White
Male > Female
Dexter L. Morris, PhD, MD
Natural History of Stroke
• Death
– 7.5% of ischemic and 37.5%
hemorrhagic stroke patients die within
30 days
• Disability
– Of those who survive 30 days, 20%
require institutional care
Dexter L. Morris, PhD, MD
Stroke Healthcare Costs
• Stroke is a leading cause of long
term disability in the US
• Approximately 1 million hospital
admissions per year for stroke
• Total costs for stroke in US over 45
BILLION dollars a year
Dexter L. Morris, PhD, MD
Summary
• Stroke is a huge disease in the United
States
• It causes a tremendous amount of
mortality and disability
• Although stroke rates may be
declining, the number of strokes will
become greater because of increases
in population and the aging of the
population
Dexter L. Morris, PhD, MD
Summary (cont)
• Hypertension is the major
controllable/treatable risk factor for
stroke
• Emergency Medicine Physicians
have an increasingly important role
in the treatment and prevention of
this disease
Dexter L. Morris, PhD, MD
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