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Name
Hospitalized Strokes
Short/Other Names

Hospitalized Stroke Event

Description

This indicator measures the age-standardized rate of new stroke events admitted to an acute care hospital for the Canadian population age 18 and older.

A new event is defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.

For further details, please see the General Methodology Notes.

Interpretation
Lower rates are desirable.
HSP Framework Dimension

Health System Outcomes: Improve health status of Canadians

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories except Quebec

Reporting Level/Disaggregation

National, Province/Territory, Region

Indicator Results

Accessing Indicator Results on Your Health System: In Depth

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<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>
Name
Hospitalized Strokes
Short/Other Names

Hospitalized Stroke Event


<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>
Description

This indicator measures the age-standardized rate of new stroke events admitted to an acute care hospital for the Canadian population age 18 and older.

A new event is defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.

For further details, please see the General Methodology Notes.

Calculation: Description

(Total number of new stroke events for persons age 18 and older ÷ Total mid-year population age 18 and older) × 100,000 (Age-adjusted)

Unit of Analysis: Single admission

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - per 100,000

Calculation: Adjustment Applied

Age-adjusted

Calculation: Method of Adjustment

Direct Standardization
Standard Population:
Canada 2011

Denominator

Description:
Total mid-year population age 18 and older

Numerator

Description:
Cases that are new stroke events admitted to an acute care hospital, age 18 and older

A new event is defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.
Inclusions:
1. Stroke present on admission (per codes specified below — coded as diagnosis type (1) or [type (M), (W), (X) or (Y), but not also as diagnosis type (2)]

Stroke diagnosis codes:

–Subarachnoid hemorrhage (ICD-10-CA: I60)

–Intracerebral hemorrhage (ICD-10-CA: I61, I62.9 [for data years prior to 2015–2016*])

–Ischemic stroke (ICD-10-CA: I63.0–I63.5, I63.8, I63.9, H34.1)

–Stroke, not specified as hemorrhage or infarction (ICD-10-CA: I64)

–Venous sinus/cortical vein thrombosis (ICD-10-CA: I63.6, I67.6, G08)

Notes

*I62.9 was used for coding hemorrhagic stroke not otherwise specified in fiscal years prior to 2015–2016. As of 2015–2016, this condition is coded to I61.9 Intracerebral haemorrhage, unspecified.

Transient ischemic attacks are not included in this indicator.

2. Age at admission 18 years and older

3. Sex recorded as male or female

4. Admission to an acute care institution (Facility Type Code = 1)
Exclusions:
1. Records with an invalid health card number

2. Records with an invalid code for province issuing health card number

3. Records with an invalid admission date

4. Cadaveric donor or stillbirth records (Admission Category Code = R or S)

5. Stroke admissions within 28 days after the admission date of the previous stroke hospitalization


<div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
Rationale

Stroke is one of the leading causes of long-term disability and death. Measuring its occurrence in the population is important for planning and evaluating preventive strategies, allocating health resources and estimating costs. From a disease surveillance perspective, there are three groups of strokes: fatal events occurring out of the hospital, non-fatal strokes managed outside acute care hospitals and non-fatal strokes admitted to an acute care facility. Although strokes admitted to a hospital do not reflect all stroke events in the community, this information provides a useful and timely estimate of the disease occurrence in the population.

Interpretation

Lower rates are desirable.

HSP Framework Dimension

Health System Outcomes: Improve health status of Canadians

Areas of Need

Not applicable

Targets/Benchmarks

Not applicable

References

Heart and Stroke Foundation of Canada. The Growing Burden of Heart Disease and Stroke in Canada 2003. Available at http://publications.gc.ca/collections/Collection/H1-10-2003E.pdf. Accessed March 01, 2014.

Johansen HL et al. Incidence, Comorbidity, Case Fatality and Readmission of Hospitalized Stroke Patients in Canada. Canadian Journal of Cardiology. 2006; 22: 65-71.

Truelsen T, Bonita R and Jamozik K. Suveillance of Stroke: A Global Perspective. International Journal of Epidemiology. 2001;30:S11-S16.

World Health Organization. WHO STEPS Stroke Manual: The WHO STEPwise Approach to Stroke Surveillance. Geneva, Switzerland: WHO, 2006.


<div role="button" class="expandableTitle" aria-controls="availabilityRegion">Availability of Data Sources and Results</div>
Data Sources

DAD

Available Data Years

Type of Year:
Fiscal
First Available Year:
2010
Last Available Year:
2015

Geographic Coverage

All provinces/territories except Quebec

Reporting Level/Disaggregation

National, Province/Territory, Region


<div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
Update Frequency

Every year

Indicator Results

Web Tool:
Your Health System: In Depth
URL:
Accessing Indicator Results on Your Health System: In Depth

Updates

Not applicable


<div role="button" class="expandableTitle" aria-controls="qualityRegion">Quality Statement</div>
Caveats and Limitations

Not applicable

Trending Issues

Not applicable

Comments

This indicator includes all new hospitalized stroke events in the reference period, encompassing first-ever and recurrent strokes. A person may have more than one stroke event in the reference period. Stroke events not admitted to an acute care hospital and in-hospital strokes are not included in this indicator.

Note that it is not possible to identify strokes resulting from occlusion of pre-cerebral arteries in the ICD-9 coding system; these strokes are included in this indicator.

Rates for Quebec are not available due to differences in data collection.

Indicator results are also available on

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