Incidence trend and spatial clustering of stroke in Baoshan District from 2017 to 2023
WU Cui1, HE Fan1, WU Jing1, XU Yanting2, WAN Jinbao1, XU Huiqin3, YANG Mingzhen4, WANG Lan2, MENG Yang1
1. Baoshan District Center for Disease Control and Prevention (Baoshan District Institute of Public Health Supervision), Shanghai 201901, China; 2. The College of Architecture and Urban Planning, Tongji University, Shanghai 200092, China; 3. Dachang Town Community Health Service Center, Baoshan District, Shanghai 200442, China; 4. Gucun Town Community Health Service Center, Baoshan District, Shanghai 201906, China
Abstract：Objective To analyze the incidence trend and spatial clustering of stroke in Baoshan District of Shanghai Municipality from 2017 to 2023, so as to provide the evidence for formulating stroke prevention and control measures. Methods Stroke case data including age, gender, onset date, and disease code in Baoshan District from 2017 to 2023 were collected through the Shanghai Stroke and Acute Myocardial Infarction Registration and Reporting System. The annual percent change (APC) was used to analyze the temporal trend of stroke incidence from 2017 to 2023, and spatial autocorrelation analysis was used to evaluate the spatial clustering of stroke onset. Results A total of 51 107 stroke cases were reported in Baoshan District from 2017 to 2023, with a crude incidence of 337.55/105 and a standardized incidence of 148.88/105, and the overall trends were not statistically significant (APC=8.107%, 5.842%, both P>0.05). The crude and standardized incidence of hemorrhagic stroke showed significant upward trends (APC=8.128%, 6.457%, both P<0.05). No significant trends were observed in the crude incidence (APC=8.056%, 11.904%) and standardized incidence (APC=5.684%, 11.496%) of ischemic stroke and unclassified stroke (all P>0.05). The crude incidence of stroke in males was 383.74/105, with a significant increasing trend (APC=8.899%, P<0.05); while the standardized incidence was 173.93/105, with no statistical significance (APC=6.864%, P>0.05). For females, the crude incidence was 290.57/105 and the standardized incidence was 122.46/105, with no statistical significance (APC=7.123%, 4.482%, both P>0.05). The crude incidence of the <35 years, 35-<45 years, 45-<55 years and 55-<65 years age groups were 4.11/105, 33.54/105, 131.24/105 and 334.29/105, respectively, presenting significant upward trends (APC=11.454%, 9.654%, 8.438%, 8.437%, all P<0.05). Spatial autocorrelation analysis showed a positive spatial correlation of stroke incidence in Baoshan District, with a Moran's I value of 0.254 (P<0.05). High-high clusters were mainly concentrated in the eastern and southeastern regions. Conclusions The overall stroke incidence trend remained stable in Baoshan District from 2017 to 2023. However, increasing incidence trends were observed in hemorrhagic stroke, male and young and middle-aged population. Stroke incidence present spatial clustering, with the eastern and southeastern areas as high-incidence regions.
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