Supplementary Material for: Time Trends in Incidence of Pathological and Etiological Stroke Subtypes during 16 Years: The Erlangen Stroke Project

<b><i>Background:</i></b> Population-based data, which continuously monitors<b> </b>time trends in stroke epidemiology are limited. We investigated the incidence of pathological and etiological stroke subtypes over a 16 year time period. <b><i>Methods:</i></b> Data were collected within the Erlangen Stroke Project (ESPro), a prospective, population-based stroke register in Germany covering a total study population of 105,164 inhabitants (2010). Etiology of ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. <b><i>Results:</i></b> Between January 1995 and December 2010, 3,243 patients with first-ever stroke were documented. The median age was 75 and 55% were females. The total stroke incidence decreased over the 16 year study period in men (Incidence Rate Ratio 1995-1996 vs. 2009-2010 (IRR) 0.78; 95% CI 0.58-0.90) but not in women. Among stroke subtypes, a decrease in ischemic stroke incidence (IRR 0.73; 95% CI 0.57-0.93) and of large artery atherosclerotic stroke (IRR 0.27; 95% CI 0.12-0.59) was found in men and an increase of stroke due to small artery occlusion in women (IRR 2.33; 95% CI 1.39-3.90). <b><i>Conclusions:</i></b> Variations in time trends of pathological and etiological stroke subtypes were found between men and women that might be linked to gender differences in the development of major vascular risk factors in the study population.

<b><i>背景：</i></b> 持续监测卒中流行病学时间趋势的基于人群研究数据较为有限。本研究针对16年间的病理学及病因学卒中亚型发病率展开了调查。
<b><i>方法：</i></b> 研究数据来源于德国埃尔朗根卒中项目（Erlangen Stroke Project, ESPro）——一项前瞻性基于人群的卒中登记研究，2010年时其覆盖的研究人群总计105164名居民。缺血性卒中的病因学分类采用急性卒中治疗Org 10172试验（Trial of Org 10172 in Acute Stroke Treatment, TOAST）标准。
<b><i>结果：</i></b> 1995年1月至2010年12月期间，共记录3243例首次卒中患者，患者中位年龄为75岁，女性占比55%。男性群体的总卒中发病率在16年研究周期内呈下降趋势（1995-1996年与2009-2010年相比，发病率比IRR=0.78；95%置信区间CI：0.58-0.90），而女性群体未出现此变化。按卒中亚型分析可见，男性群体的缺血性卒中发病率（IRR=0.73；95%CI：0.57-0.93）及大动脉粥样硬化性卒中发病率均有所下降；女性群体的小动脉闭塞性卒中发病率则呈上升趋势（IRR=2.33；95%CI：1.39-3.90）。
<b><i>结论：</i></b> 本研究发现男性与女性的病理学及病因学卒中亚型时间趋势存在差异，该差异或与研究人群中主要血管危险因素的性别差异相关。