Current trends in stroke events, mortality, and case fatality in Switzerland: an epidemiologic update

Background Stroke is a major cardiovascular disease. The last epidemiologic update of stroke events, mortality, and case fatalities (CF) in Switzerland was performed in 2004. Between 2004 and 2017, traditional- and non-traditional cardiovascular risk factors changed, life expectancy increased, stroke units were implemented, and stroke treatment standardized. Therefore, we present an update of Swiss stroke epidemiology. Methods Data were obtained from two databases, the Federal Hospital Discharge Statistics (HOST, n = 1 470 259) and the Cause of Death (CoD) database (n = 66 971), to analyze stroke diagnoses coded according to I60-I64 (ICD 10) in 2017 in Switzerland. Discharge- and event rates for stroke, in- and out-of-hospital CF, and mortality were calculated. Results In 2017, there were 26 032 stroke discharges in Switzerland (45% women) compared to 13 996 discharges in 2004. The age-standardized event rate per 100 000 increased in women/men from 119.7/178.7 in 2004 to 265.1/396.7 in 2017. However, the absolute number of stroke deaths decreased between 2004 and 2017 from 3569 (60% women) to 2816 (59% women). The overall sex-stratified mortality rate approximately halved between 2004 and 2017 in women (from 77.5 to 38.5/100 000) and men (from 56.1 to 27.2/100 000). The overall CF halved between 2004 and 2017 from 22.7% to 10.5% and was higher in women (13.4%) compared to men (8.0%). Conclusions Compared to 2004, the rates of stroke events and discharges have increased in Switzerland. However, the overall CF rate and overall sex-stratified mortality rate has approximately halved. This suggests, among other factors, increased recognition and better treatments for stroke.