PT  - JOURNAL ARTICLE
AU  - Runhua Zhang
AU  - Yu Wang
AU  - Jiming Fang
AU  - Miaoxin Yu
AU  - Yongjun Wang
AU  - Gaifen Liu
TI  - Worldwide 1-month case fatality of ischaemic stroke and the temporal trend
AID  - 10.1136/svn-2020-000371
DP  - 2020 Jul 12
TA  - Stroke and Vascular Neurology
PG  - svn-2020-000371
4099  - http://svn.bmj.com/content/early/2020/07/12/svn-2020-000371.short
4100  - http://svn.bmj.com/content/early/2020/07/12/svn-2020-000371.full
AB  - Background The 1-month case fatality of ischaemic stroke is an essential epidemiological metric. Whereas the case fatality after ischaemic stroke and the temporal trend is uncertain. We aimed to estimate the 1-month case fatality of ischaemic stroke and its temporal trend, as well as its regional variation.Methods We searched PubMed and Embase to identify the studies for 1-month case fatality of ischaemic stroke . The population-based studies were included. Two investigators extracted the data and assessed the quality independently. One-month case fatality of ischaemic stroke was estimated using a random effects model. The temporal trend was evaluated using a mixed-effect meta-regression model.Results A total of 59 articles with 77 time periods were included. The worldwide 1-month case fatality of ischaemic stroke was 13.5% (95% CI 12.3% to 14.7%). The case fatality was 10.8% (95% CI 8.3% to 13.5%) in Asia, 14.2% (95% CI 12.6% to 15.9%) in Europe, 14.0% (95% CI 11.2% to 17.1%) in South America and Caribbean, 14.0% (95% CI 9.5% to 19.1%) in North America and 12.5% (95% CI 11.1% to 13.9%) in Australia and New Zealand. Overall, there was a non-significant decrease of 0.1% per year in case fatality. It decreased significantly in Europe (−0.2% annually, 95% CI −0.4% to −0.01%) and North America (−0.2% annually, 95% CI −0.4% to −0.04%), increased significantly in Australia and New Zealand (0.2% annually, 95% CI 0.1% to 0.4%), while no evidence of change in other regions.Conclusion The 1-month case fatality of ischaemic stroke and its temporal trend were divergent across regions. Further studies are needed to address the reason of the regional difference, which will be helpful to guide the effort of reducing stroke burden.