Supplementary Material for: Early and One-Year Outcomes of Acute Stroke in the Industrial Region of Poland During the Decade 2006–2015: The Silesian Stroke Registry

<b><i>Background:</i></b> Poland, classified as a high-income country, is still considered to have a high cardiovascular risk population. During the last decade, the standards of care in acute stroke (AS) had markedly improved; thus, we aimed to assess whether and how it translated into early and late outcomes. <b><i>Methods:</i></b> Silesian Stroke Registry was created from the administrative database of the public, obligatory, health ­insurer in Poland. The AS cases were selected based on primary diagnosis coded in ICD-10 as I60-I64 for years 2006–2015 (<i>n</i> = 120,844). Index hospitalization together with data on re-hospitalizations, procedures, ambulatory visits, rehabilitation and all-cause deaths in a 1-year follow-up were analyzed. <b><i>Results:</i></b> The rates of admissions per 100,000 adult population varied between 41–47 for haemorrhagic and 257–275 for ischaemic stroke with substantial decrease in almost all age groups except for the oldest patients. In ischaemic stroke, thrombolytic therapy raised from 0 to 8.8% in 2015, along with significant trends of decreasing 30-day (from 20 to 16%) and 12-month (from 35 to 31%) case fatality. In haemorrhagic stroke, case fatality had not changed. After ischaemic stroke, 12-month readmissions due to AS declined from 11–12% in 2006–2009 to 9% in 2010–2014. The percentage of patients benefiting from rehabilitation increased from 24 to 32%. <b><i>Conclusions:</i></b> In a large population of industrial province, we showed recent, positive trends in AS admissions, treatment and 1-year outcomes. Development of stroke unit networks and increase in thrombolytic treatment were at least in part responsible for survival improvement and reduction of recurrence of AS. However, case-fatality and stroke recurrence remain high compared to those of other developed countries.

<b><i>背景：</i></b> 波兰虽属高收入国家，但其心血管疾病高危人群占比仍居高不下。近十年来，急性卒中（acute stroke, AS）的诊疗规范已得到显著改善，本研究旨在评估该变革是否以及如何体现在急性卒中的早期与远期预后中。<b><i>方法：</i></b> 本研究依托波兰公立强制健康保险公司的行政数据库，建立了西里西亚卒中登记库（Silesian Stroke Registry）。研究纳入2006至2015年间，以国际疾病分类第10版（International Classification of Diseases 10th Revision, ICD-10）编码I60-I64作为主要诊断的急性卒中病例，共计120844例。分析内容涵盖患者的首次住院信息、1年随访期内的再住院情况、诊疗操作、门诊就诊记录、康复治疗数据以及全因死亡结局。<b><i>结果：</i></b> 每10万成人人口的急性卒中入院率，出血性卒中为41~47例，缺血性卒中为257~275例；除高龄患者群体外，其余各年龄组的入院率均出现明显下降。在缺血性卒中患者中，溶栓治疗的应用比例从0提升至2015年的8.8%，同时30天病例病死率（从20%降至16%）与12个月病例病死率（从35%降至31%）均呈现显著下降趋势。出血性卒中的病例病死率则无明显变化。缺血性卒中患者因急性卒中导致的12个月再住院率，从2006-2009年的11%~12%降至2010-2014年的9%。接受康复治疗的患者占比从24%提升至32%。<b><i>结论：</i></b> 本研究针对大型工业省份的人群队列显示，急性卒中的入院特征、诊疗方案与1年预后均呈现向好发展趋势。卒中单元（stroke unit）网络的建设与溶栓治疗的普及，至少部分推动了患者生存率的提升与急性卒中复发率的降低。但与其他发达国家相比，当前急性卒中的病例病死率与复发率仍处于较高水平。