• Chuen Seng Tan, Falk Müller-Riemenschneider, Sheryl Hui Xian Ng, Pei Zheng Tan, Bernard P L Chan, Kok-Foo Tang, Aftab Ahmad, Keng He Kong, Hui Meng Chang, Khuan Yew Chow, KohGerald Choon-HuatGCFrom the Saw Swee Hock School of Public Health, National University Health System, Singapore (C.S.T., F.M.-R., S.H.X.N., G.C.-H.K.); Yong Loo Lin School of Medicine, National University of Singapore, Singapore (F.M.-R., P.Z.T., G.C.-, Narayanaswamy Venketasubramanian, and Singapore Stroke Registry.
• From the Saw Swee Hock School of Public Health, National University Health System, Singapore (C.S.T., F.M.-R., S.H.X.N., G.C.-H.K.); Yong Loo Lin School of Medicine, National University of Singapore, Singapore (F.M.-R., P.Z.T., G.C.-H.K.); Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany (F.M.-R.); Division of Neurology, National University Hospital, National University Health System, Singapore (B.P.L.C.); Tang Neurology & Medical Clinic, Mount Elizabeth Medical Centre, Singapore (K.-F.T.); Medicine Department, Jurong Health, Singapore (A.A.); Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore (K.H.K.); National Neuroscience Institute, Singapore General Hospital Campus, Singapore (H.M.C.); National Registry of Disease Office, Health Promotion Board, Singapore (K.Y.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore (N.V.).
• Stroke. 2015 Oct 1; 46 (10): 2728-34.

Background And PurposeThis study investigated trends in stroke incidence and case fatality overall and according to sex, age, ethnicity, and stroke subtype in a multiethnic Asian population.MethodsThe Singapore Stroke Registry identifies all stroke cases in all public hospitals using medical claims, hospital discharge summaries, and death registry data. Age-standardized incidence rates and 28-day case-fatality rates were calculated for individuals aged ≥15 years between 2006 and 2012. To estimate the annual percentage change of the rates, a linear regression model was fitted to the log rates, and a Wald test was performed to test for trend. P values <0.05 were considered significant.ResultsA total of 40 623 cases were recorded. The total stroke incidence fell by ≈12.0%, and case fatality fell by 17.2% in the study. Declining trends in stroke incidence were stronger in women (female: -2.94; 95% confidence interval [CI], -3.43 to -2.44; male: -1.80; 95% CI, -2.58 to -1.02); in the older age groups (≥65 years: -3.62; 95% CI, -4.30 to -2.94; 50-64 years: -1.26; 95% CI, -1.97 to -0.55; <50 years: 3.33; 95% CI, 1.49 to 5.20), in Chinese (-2.64; 95% CI, -3.15 to -2.13), Indians (-3.78; 95% CI, -5.93 to -1.58), and others (-12.73; 95% CI, -18.93 to -6.06) compared with Malays (2.58; 95% CI, 1.17 to 4.02); and in ischemic stroke subtype (ischemic: -2.43; 95% CI, -3.13 to -1.73; hemorrhagic: -1.02; 95% CI, -2.04 to 0.01). Subgroup-specific findings for case fatality were similar.ConclusionThis is the first countrywide hospital-based registry study in a multiethnic Asian population, and it revealed marked overall reductions in stroke incidence and case fatality. However, it also identified important population groups with less favorable trends, especially younger adults and those of Malay ethnicity.© 2015 American Heart Association, Inc.

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