20152022年浙江省余姚市脑卒中死亡流行病学特征

Epidemiological characteristics of stroke mortality in YuyaoZhejiang Province2015‒2022

  • 摘要:
    目的 分析2015—2022年浙江省余姚市脑卒中死亡数据,为该市及同等发展程度县级市/区制定科学有效的脑卒中防治策略提供参考依据。
    方法 收集死亡日期为2015—2022年余姚市全部脑卒中死亡病例信息,计算粗死亡率(CMR)、中标死亡率、世标死亡率、35~64岁截缩死亡率、0~74岁累积死亡率、过早死亡率、潜在减寿年数(PYLL)、平均减寿年数(AYLL)、潜在减寿年数率(PYLLR)和平均年度变化百分比(AAPC)等数据。组间率的比较采用χ2检验;拟合线性回归计算AAPC并分析死亡率变化趋势。
    结果 2015—2022年余姚市居民脑卒中死亡6 533例,缺血性脑卒中占70.60%,出血性脑卒中占29.40%。平均CMR为97.67/10万,中标死亡率为45.82/10万,世标死亡率为32.10/10万,8年间CMR、中标死亡率、世标死亡率变化趋势均无统计学意义(均P>0.05)。脑卒中死亡主要集中在冬季(12月—次年2月),占31.21%。脑卒中男性死亡率(108.15/10万)高于女性(87.49/10万),差异有统计学意义(χ2=73.195,P<0.001)。脑卒中死亡率随年龄的增长呈上升趋势(χ2趋势=17 839.150,P<0.001),在85~岁组达到死亡率峰值(1 867.82/10万)。10~64岁年龄组出血性脑卒中死亡率高于缺血性脑卒中,65岁以上年龄组人群缺血性脑卒中死亡率高于出血性脑卒中。脑卒中死亡所致PYLL为11 014.00人年,AYLL为10.98年,PYLLR为1.87‰。
    结论 余姚市脑卒中死亡率相对平稳,需要以男性和老年人群为重点人群,开展以社区健康教育,脑卒中发生风险评估、筛查及干预,患者双向转诊,分等级康复为一体的慢性病社区综合干预工作机制,降低死亡率,减少寿命损失。

     

    Abstract:
    Objective To analyze stroke mortality data from Yuyao, Zhejiang Province, from 2015 to 2022, and to provide references for the development of effective stroke prevention and control strategies in Yuyao and similar county-level cities or districts.
    Methods Data on all stroke-related deaths in Yuyao from 2015 to 2022 were collected. Metrics including crude mortality rate (CMR), Chinese-standardized mortality rate, world-standardized mortality rate, truncated mortality rate (35‒64 years), cumulative mortality rate (0‒74 years), premature mortality rate, potential years of life lost (PYLL), average years of life lost (AYLL), PYLL rate (PYLLR), and average annual percentage change (AAPC) were calculated. Differences between groups were compared using the Chi-square test. Linear regression was utilized to calculate AAPC and analyze mortality trends.
    Results From 2015 to 2022, a total of 6 533 stroke deaths were recorded among residents in Yuyao, with ischemic stroke accounting for 70.60% and hemorrhagic stroke accounting for 29.40%. The average CMR was 97.67/100 000, China-standardized mortality rate was 45.82/100 000, and world-standardized mortality rate was 32.10/100 000. No statistically significant differences were observed in CMR, China-standardized morality rate, or world-standardized mortality rate over the 8 years (all P>0.05). Stroke deaths primarily occurred in winter (from December to February of next year), accounting for 31.21% of the cases. Male stroke mortality rate (108.15/100 000) was significantly higher than female mortality rate (87.49/100 000, χ2=73.195, P<0.001). Stroke mortality rate increased significantly with age (χ2trend=17 839.150, P<0.001), peaking at 1 867.82/100 000 in the ≥85-year-old age group. Hemorrhagic stroke mortality rate was higher than ischemic stroke mortality rate in the 10‒64-year-old age group, whereas ischemic stroke mortality rate exceeded hemorrhagic stroke mortality rate in those aged 65 years and above. The PYLL caused by stroke mortality was 11 014.00 person-years, with an AYLL of 10.98 years, and a PYLLR of 1.87‰.
    Conclusion Stroke mortality in Yuyao has remained relatively stable. A community-based comprehensive chronic disease intervention mechanism should be established, with a focus on males and the elderly. This mechanism should integrate community health education, stroke risk assessment, screening and intervention, two-way patient referral systems, and tiered rehabilitation services to reduce mortality rate and mitigate life expectancy loss.

     

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