A study on the characteristics and hospitalization rates of stroke admissions in class 2 and 3 hospitals in Guangzhou, China, 2013

Abstract

Background: Cardio-and Cerebrovascular Disease Event Surveillance System (CDESS) was established in Guangzhou in 2013. It provided important information of the stroke hospitalization and set up a platform for further research on stroke. Objective: To describe the characteristics of stroke hospitalizations in Class 2 and 3 hospitals, examine crude and standardized hospitalization rates by age, sex and stroke subtypes, identify problems in the first year database through the analysis and make recommendations for further improvements Design: Case-series study Setting: Guangzhou, China Subjects: 32324 stroke hospitalizations in Class 2 and 3 hospitals Methods: Descriptive statistics were used to describe the distributions of stroke hospitalizations by age, sex and subtypes. Chi-square test, One-way ANOVA and two-independent sample t-test were conducted to compare differences in sex and age in total strokes and 3 main subtypes. Crude rates, age- and sex-specific hospitalization rates were calculated using the 2010 Guangzhou Census population. Age-standardized rates were calculated by direct standardization method using the WHO world population. Results: The mean age±SD for total strokes was 70.33±12.26 for all subjects, 68.95±12.56 for men and 72.19±11.59 for women. CBI and the 75-79 year age group accounted for the largest proportions in total strokes. The mean age of women was significantly greater than men for total stroke. The crude hospitalization rate of total strokes was 275.22 for men, 224.16 for women and 250.85 for all. The age-standardized rate of total strokes was 308.2 in men, 202.2 in women and 253.5 in all. Conclusion: Because the stroke hospitalization data combined first-ever and recurrent strokes, incident hospitalization rates could not be calculated. The present study also could not distinguish fatal hospitalizations from nonfatal ones. Hence, bed days and hospital charges analysis would not yield meaningful results. The CDESS needs to be improved by collecting information to clarify whether the hospitalization is first-ever or recurrent, and the survival status at discharge. The mortality data from death registration in CDC should be used to check with CDESS data for stroke death outside the hospitals Community based studies are needed to identify strokes not admitted into Class 2 and 3 hospitals. The problems identified in CDESS or WHO STEP Stroke should be discussed with other hospitals in China, such as Hangzhou and Shanghai so that the problems can be tackled together.