Stroke rates: 1980-2000

Kamakshi Lakshminarayan, David C. Anderson, David R. Jacobs, Cheryl A. Barber, Russell V. Luepker

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


In this paper, the authors report trends in hospitalized stroke rates among Minneapolis-St. Paul, Minnesota (population 2.6 million) metropolitan area residents aged 30-74 years from 1980 to 2000. Cases were identified from lists of discharge diagnoses provided by hospitals serving the target population. Age-adjusted, sex-specific stroke attack rates were computed for each survey year by using 5 different diagnostic definitions: 2 based purely on International Classification of Diseases, Ninth Revision (ICD-9) codes and 3 including clinical and neuroimaging criteria. Stroke rates, as measured by a highly specific clinical definition, remained stable from 1980 to 2000 for women. For men, these rates declined modestly from 1980 to 1990 and leveled off during 1990-2000. In contrast, use of stroke-related ICD-9 discharge codes declined significantly from 1980 to 2000: 35% among men and 16% among women. Neuroimaging use increased significantly from 75% of cases in 1980 to 98% in 2000. Short-term (28-day) stroke survival improved significantly, by 16% for women and 12% for men, from 1980 to 2000. The decline in stroke ICD-9 code usage reflects the influence of increased neuroimaging on discharge coding. The improved short-term survival in the face of stable, clinically defined stroke rates may imply treatment advances or ascertainment of less severe strokes, possibly masking a true decline in stroke rates.

Original languageEnglish (US)
Pages (from-to)1070-1078
Number of pages9
JournalAmerican journal of epidemiology
Issue number9
StatePublished - May 2009


  • Incidence
  • Mortality
  • Population surveillance
  • Stroke


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