Evidence map›Paper›PMID 42758057›Full record

ArticleInternational journal of epidemiology2026

The impact of temporal trends in stroke event rates and 30-day case fatality on trends in stroke mortality: an international comparative study.

Lee Nedkoff, F Lucy Wright, Nhung Nghiem, Solmaz Setayeshgar, Emmalin Buajitti, Aden C H Kwok, Dawit Zemedikun, Ximena Camacho, Samantha Stiles, Raphael Goldacre and 4 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Lee NedkoffCardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.ORCID 0000-0002-3970-625X
F Lucy WrightApplied Health Research Unit, Nuffield Department of Population Health, and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-3632-9604
Nhung NghiemJohn Curtin School of Medical Research, Australian National University, Canberra, Australia.ORCID 0000-0003-0078-4549
Solmaz SetayeshgarEpidemiology and Intelligence Services, BC Centre for Disease Control, Vancouver, BC, Canada.ORCID 0000-0003-3467-8381
Emmalin BuajittiDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-3194-7331
Aden C H KwokApplied Health Research Unit, Nuffield Department of Population Health, and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-3717-8836
Dawit ZemedikunCardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.ORCID 0000-0003-3642-0456
Ximena CamachoSchool of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-2371-1441
Samantha StilesCardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.ORCID 0009-0008-4403-4655
Raphael GoldacreApplied Health Research Unit, Nuffield Department of Population Health, and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
Kate SmolinaEpidemiology and Intelligence Services, BC Centre for Disease Control, Vancouver, BC, Canada.ORCID 0000-0001-5214-4776
Laura C RosellaDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-4867-869X
Tony BlakelyPopulation Interventions Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia.ORCID 0000-0002-6995-4369
Philip ClarkeHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Headington, United Kingdom.ORCID 0000-0002-7555-5348

Funding

National Heart Foundation #105038National Heart Foundation #108106
6 · The paper itself

Abstract

backgroundStroke mortality rates have declined in recent decades; however, data on contemporary drivers of this trend are limited. This study compared the contribution of trends in stroke event rates and 30-day case fatality to declines in stroke mortality from 2002 to 2018.

methodsLinked hospitalization and mortality data were obtained from Western Australia (WA), England, New Zealand, British Columbia (BC), and Ontario. Age-standardized and age-specific stroke mortality and event rates and 30-day case fatality were calculated and age-adjusted trends estimated from Poisson and binomial regression models. The relative contribution of trends in stroke events and 30-day case fatality to trends in stroke mortality were calculated.

resultsThere were 2 248 242 stroke events identified. Age-adjusted reductions in event rates ranged from -0.96%/year [95% confidence interval (CI) - 1.22, 0.70%] in men in WA to -2.51%/year (95% CI -2.61, -2.40%) in women in Ontario. Age-standardized 30-day case fatality was highest in England in 2002 (men 43.7%, women 45.5%), but declined at a greater rate than in other jurisdictions. Declines in stroke mortality ranged from -3.3%/year to -5.5%/year. Reductions in 30-day case fatality were the major contributor to declines in stroke mortality [range: men, 63.5% (Ontario)-80.9% (England); women, 55.3% (BC)-73.1% (England)]. In people aged <65 years, stroke mortality declines were almost completely driven by reductions in 30-day case fatality with increasing or attenuated event rates among those aged 35-64 years.

conclusionImprovements in 30-day case fatality had a greater impact on stroke mortality than trends in event rates, suggesting that further gains could be achieved with targeted prevention. Adverse trends in event rates in people aged <65 years could signal future increases in stroke mortality.

Indexed as

StrokeAdultAgedAged, 80 and overAge DistributionBritish ColumbiaEnglandFemaleHospitalizationHumansMaleMiddle AgedMortalityNew ZealandOntarioSex Distributioncase fatalityevent ratesmortalityrelative contributionsstroketrends

Identifiers

PMID42758057
PMCPMC13653606

What OpenQuestion holds

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Registered trials

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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.