Population-Based Incidence Rates of First-Ever Stroke in Central Vietnam

PLoS One. 2016 Aug 11;11(8):e0160665. doi: 10.1371/journal.pone.0160665. eCollection 2016.

Abstract

Introduction: Stroke incidence data with methodologically acceptable design in Southeast Asia countries is limited. This study aimed to determine incidence of age-, sex- and subtype-specific first-ever stroke (FES) in Vietnam.

Methods: We conducted a hospital-based retrospective study, targeting all stroke cases hospitalized at a solo-provider hospital in our study site of Nha Trang from January 2009 to December 2011 with International Classification of Diseases, 10th revision (ICD-10) codes I60-69. We calculated positive predictive values (PPVs) of each ICD-10-coded stroke by conducting a detailed case review of 190 randomly selected admissions with ICD-10 codes of I60-I69. These PPVs were then used to estimate annual incident stroke cases from the computerized database. National census data in 2009 was used as a denominator.

Results: 2,693 eligible admissions were recorded during the study period. The crude annual incidence rate of total FES was 90.2 per 100,000 population (95% CI 81.1-100.2). The age-adjusted incidence of FES was 115.7 (95% CI 95.9-139.1) when adjusted to the WHO world populations. Importantly, age-adjusted intracerebral hemorrhage was as much as one third of total FES: 36.9 (95% CI 26.1-51.0).

Conclusions: We found a considerable proportion of FES in Vietnam to be attributable to intracerebral hemorrhage, which is as high or exceeding levels seen in high-income countries. A high prevalence of improperly treated hypertension in Vietnam may underlie the high prevalence of intracerebral hemorrhagic stroke in this population.

MeSH terms

  • Age Factors
  • Hospitalization
  • Humans
  • Incidence
  • Retrospective Studies
  • Sex Factors
  • Stroke / epidemiology*
  • Vietnam

Grants and funding

This research was supported by the Japan Initiative for Global Research Network on Infectious Diseases from Japan Agency for Medical Research and development (AMED), and JSPS KAKENHI Grant Number JP15K19230.