Long-Term Trends in Stroke Management and Burden Among Low-Income Women in a Rural Area From China (1992–2019): A Prospective Population-Based Study

Abstract

Although an increasing number of studies are considering sex-related differences in stroke burden, the trends in stroke burden and management among women in China, especially among low-income women, remain unclear. This study evaluated the long-term trends in stroke management and burden among low-income Chinese women during the period between 1992 and 2019. Stroke burden was assessed using the age-adjusted incidence of first-ever stroke, whereas stroke management was assessed using the rates of neuroimaging diagnoses, hospitalizations, case fatalities, and stroke recurrence. Stroke burden and management were analyzed during four study periods: 1992–1998, 1999–2004, 2005–2012, and 2013–2019. During the 193,385 person-years of surveillance in this study, 597 female stroke patients were identified. The stroke incidences per 100,000 person-years were 88.1 cases during 1992–1998, 145.4 cases during 1999–2004, 264.3 cases during 2005–2012, and 309.8 cases during 2013–2019 (P < 0.001). Between 1992 and 2019, the incidence of stroke significantly increased (6.4% annually) as did the incidence of ischemic stroke (7.8% annually; both, P < 0.001). The rates of neuroimaging diagnoses and hospitalizations significantly increased during the four periods, while the case fatality rates and 1-year recurrence rates decreased significantly for both overall strokes and ischemic strokes, especially among patients ≥45 years old (all, P < 0.001). Among low-income women in China, stroke management is gradually improving, despite the increasing stroke burden. Thus, improved healthcare coverage is needed to further reduce the stroke burden among low-income Chinese women.

The relationship between social and psychological factors with cognitive impairment after stroke: a prospective study

“…A multi-center study revealed that 62.7% of stroke survivors necessitated psychological support, and underscored the insufficiency of available psychological support services ( 29 ). Additionally, while health insurance now covers over 95% of Chinese citizens ( 30 ), there is still a lack of resources to address mental health needs, which is attributed to constraints in medical resources. The limited availability of rehabilitation services indicates the neglect of aspects crucial for maximizing recovery in speech, cognitive, and emotional function recovery in China, despite the significant demand for psychological support among Chinese stroke patients.…”

Stroke in women between 2006 and 2018: Demographic, socioeconomic, and age disparities

“…1 Further complicating the unexplained race and sex variations in stroke prevalence, these disparities are not consistent over time. 14 Ageadjusted prevalence of first ischemic stroke is more than twice as high in Black as in White individuals and the Black/White prevalence rate ratio is the highest at midlife and decreases thereafter. 15 Race and sex-stratified analyses suggest that these racial disparities are more pronounced and significant in women.…”

Relationship between mean corpuscular volume and 30-day mortality in patients with intracerebral hemorrhage: Evidence from the MIMIC-III database

“…A population-based study from 2013 to 2019 in China showed that the prevalence of stroke increased annually, from 2.28% in 2013 to 2.58% in 2019, and it was higher for male sex, older age, and residence in rural. [1] Intracerebral hemorrhage (ICH) is a common subtype of stroke with a high incidence (10%‐15% of all strokes), high mortality (40.4% at 1 month), and poor prognosis. [2,3] Hemorrhages have attracted the attention of researchers for years due to the neurotoxicity they can cause in the central nervous system.…”