ArticleBMJ (Clinical research ed.)2019
Determinants of the decline in mortality from acute stroke in England: linked national database study of 795 869 adults.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 64 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Ethnicity and health-related quality of life in the post stroke population: a systematic review.Journal of rehabilitation medicine · 2025Pooled it
- Motivational support intervention to reduce smoking and increase physical activity in smokers not ready to quit: the TARS RCT.Health technology assessment (Winchester, England) · 2023Pooled it
- Actor-partner effects of wellbeing, hope and self-esteem on depression in stroke survivor-caregiver dyads: A randomized controlled trial.Clinical rehabilitation · 2023Trial
- Demographics, risk factor profiles and etiologies in young ischemic and hemorrhagic stroke - the United Kingdom Young Stroke Study (UKYSS).Journal of neurology · 2026Observational
- The impact of temporal trends in stroke event rates and 30-day case fatality on trends in stroke mortality: an international comparative study.International journal of epidemiology · 2026Article
- Acute non-alcoholic caffeinated beverage consumption as a trigger for cryptogenic ischemic stroke in the young: findings from the SECRETO study.Journal of neurology · 2026Observational
- Co-existence of Possible Sarcopenia and Dysphagia is Associated with Poor Functional Outcomes in Patients with Acute Stroke: A 1-Year Follow-up Study.Annals of geriatric medicine and research · 2026Observational
- Machine learning models powered by emergency medical services data enhance stroke triage in prehospital settings.Scientific reports · 2026Article
- Seeing the Small to Prevent the Big: The Role of Cerebral Microvessels in Ischemic Stroke Etiology and Prevention.Stroke research and treatment · 2026Review
- United Kingdom Young Stroke Study (UKYSS): study protocol for an ambispective observational study.BMJ neurology open · 2026Article
- Elevated acute-phase plasma levels of S100A12 [EN-RAGE] are associated with vascular recurrence after ischemic stroke.European stroke journal · 2026Article
- Risk prediction models for venous thromboembolism in stroke: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Review
- Young stroke: An update on epidemiology, emerging risk factors, and future research directions.International journal of stroke : official journal of the International Stroke Society · 2026Review
- Nationwide Trends in Incidence of Stroke and Transient Ischemic Attack in Younger and Older Adults in Norway 2001 to 2021.Journal of the American Heart Association · 2025Article
- Consciousness Disorders and Swallowing Difficulties.Dysphagia · 2025Review
- Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019.Lancet (London, England) · 2025Article
- Cost-effectiveness of ten commonly used antipsychotics in first-episode schizophrenia in the UK: economic evaluation based on aThe British journal of psychiatry : the journal of mental science · 2025Article
- Direct medical cost of first-ever acute ischemic stroke in malaysia: a retrospective cohort study.Scientific reports · 2025Article
- Fatty Acid Ratios Versus Conventional Risk Factors in Stroke: Insights into Severe Disability and Mortality Outcomes.Nutrients · 2025Article
- Initial calf circumference predicts poor disability outcomes in patients with stroke.The journal of nutrition, health & aging · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo study trends in stroke mortality rates, event rates, and case fatality, and to explain the extent to which the reduction in stroke mortality rates was influenced by changes in stroke event rates or case fatality.
designPopulation based study.
settingPerson linked routine hospital and mortality data, England.
participants795 869 adults aged 20 and older who were admitted to hospital with acute stroke or died from stroke.
main outcome measuresStroke mortality rates, stroke event rates (stroke admission or stroke death without admission), and case fatality within 30 days after stroke.
resultsBetween 2001 and 2010 stroke mortality rates decreased by 55%, stroke event rates by 20%, and case fatality by 40%. The study population included 358 599 (45%) men and 437 270 (55%) women. Average annual change in mortality rate was -6.0% (95% confidence interval -6.2% to -5.8%) in men and -6.1% (-6.3% to -6.0%) in women, in stroke event rate was -1.3% (-1.4% to -1.2%) in men and -2.1% (-2.2 to -2.0) in women, and in case fatality was -4.7% (-4.9% to -4.5%) in men and -4.4% (-4.5% to -4.2%) in women. Mortality and case fatality but not event rate declined in all age groups: the stroke event rate decreased in older people but increased by 2% each year in adults aged 35 to 54 years. Of the total decline in mortality rates, 71% was attributed to the decline in case fatality (78% in men and 66% in women) and the remainder to the reduction in stroke event rates. The contribution of the two factors varied between age groups. Whereas the reduction in mortality rates in people younger than 55 years was due to the reduction in case fatality, in the oldest age group (≥85 years) reductions in case fatality and event rates contributed nearly equally.
conclusionsDeclines in case fatality, probably driven by improvements in stroke care, contributed more than declines in event rates to the overall reduction in stroke mortality. Mortality reduction in men and women younger than 55 was solely a result of a decrease in case fatality, whereas stroke event rates increased in the age group 35 to 54 years. The increase in stroke event rates in young adults is a concern. This suggests that stroke prevention needs to be strengthened to reduce the occurrence of stroke in people younger than 55 years.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.