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RESEARCH PRODUCT

L’accident vasculaire cérébral en France : patients hospitalisés pour AVC en 2014 et évolutions 2008-2014

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ntroduction – In France, stroke is the first cause of death in women, and the third in men. The age-standardized rates of patients hospitalized for stroke increased in patients younger than 65 years between 2002 and 2008. After the implementation of the “National Stroke Action Plan” (2010-2014), this study analyzed trends in the rates of patients hospitalized for stroke and of patients hospitalized in stroke units since 2008.Methods – Data came from the French national hospital discharge databases (PMSI-MCO, 2008-2014). For each patient, the first annual hospitalization for stroke was selected. Crude hospitalized patients and in-hospital mortality rates were calculated by stroke subtypes, age group and sex, and then were age-standardized. Time trends were tested using a Poisson regression model.Results – In 2014, 110,438 patients were hospitalized for stroke. The proportion of patients hospitalized in a stroke unit was 51.5% for ischemic stroke (IS) and 33.2% for intracerebral hemorrhage. From 2008 to 2014, the age-standardized rate of patients hospitalized for IS increased by 14.3% in patients aged less than 65 years, and decreased by 2.1% in those aged 65 and over. In contrast, for hemorrhagic stroke, the rate barely changed (+2.0%). During the same period, in-hospital mortality decreased by 12.5% in IS patients. Important regional disparities were observed in the rates of patients hospitalized for stroke.Conclusion – The encouraging increase in the proportion of patients hospitalized in stroke units and the decrease in in-hospital mortality should not hide three major observations: the stabilization of the rates of hospitalized patients for stroke (overall) in a context of population aging, the increase in patients hospitalized rates for IS in young adults, and important regional disparities in patients hospitalized rates.