Study On The Trends Of The Disease Burden And Survival Analysis About Stroke In Jinchang Cohort

Objective Through the comprehensive analysis of the trend of the death rate,the degree of harm and the direct economic burden of stroke patients in the cohort,to obtain the distribution of stroke in Jinchang Cohort and to determine high risk population of stroke,in order to understand the natural history of stroke in the cohort population.To provide a scientific basis for health intervention in Jinchang Corhort,as well as to provide a scientific guidance for the prevention and treatment work of stroke.Method 1.All the employees and retired workers of Jinchuan Group Co.Ltd were selected as the research objects from 2001 to 2013.A follow-up study was established by collecting data of death of all objects.The data were utilized to analyze the change trend of the death rate of stroke and disease severity in the cohort.2.The follow-up study in the descriptive study was established by collecting the medical records of inpatients with complete medical records from 2001 to 2010,using the cluster sampling method.The cases of stroke patients were selected as the subjects,and the tendency of the direct economic burden of stroke in Jinchang Cohort was analyzed.3.Based on the data of the medical records and death records,the fixed cohort of patients who were hospitalized for stroke in 2001 was selected as the survival analysis data to establish the historical cohort study.Survival rate was calculated by Kaplan-Meier estimation and risk factors of stroke were analyzed by proportional risk regression model.Result 1.The death cases of stroke in Jinchang Cohort were 547,and the mortality rate was 98.38/100000 from 2001 to 2013.Male mortality was higher than those of females with average increase speed of 3.49%.Stroke mortality in the group 70 years and above was highest,1054.60/100000.The hemorrhagic mortality rate was 59.71/100000,and the male was higher than those of the female.The ischemic stroke mortality rate was 34.89/100000 with average increase speed of 4.44%,and male mortality was also higher than those of the female.2.Stroke caused total PYLL in the Jinchang Cohort was 4783.04 person-years,and the potential years of life lost(APYLL)was 8.74 years.PYLL was higher in males than those of in females,but APYLL was higher in females than those of in males.Hemorrhagic stroke caused PYLL and APYLL were 3640.61 person-years and 10.97 years respectively,which were 3.78 and 2.21 times of ischemic stroke respectively.The stroke caused PYLL and APYLL were highest in the workers from smelting chemical unit,1734.79 person-years and 11.19 years respectively.3.Stroke caused total WPYLL in the Jinchang Cohort was 2071.50 person-years,and the working years of potential life lost(APYLL)was 3.79 years.The hemorrhagic stroke caused WPYLL and APYLL were 1685.50 person-years and 5.08 years respectively,which were 5.49 and 3.21 times of ischemic stroke respectively.The stroke caused WPYLL and AWPYLL in the workers from the smelting chemical unit population were both the highest,869.00 person-years and 5.61 years respectively.4.The stay length per time was 18.97 days/time,the average hospitalization expenses of each time was 5417.68 yuan/time,and the average daily hospitalization expenses of each time was 285.59 yuan/day in the Jinchang Cohort.Those indexes of male stroke patients were higher than those of female.Those indexes in the group under 55 years old were all the highest.Those indexes in the hemorrhagic stroke patients were higher than those of ischemic stroke.Those indexes in the workers from the mining and mineral processing unit were all the highest.5.The average stay length,average hospitalization expenses and the average daily hospitalization expenses per capita of stroke patient were 23.53 days/person,6719.12 yuan/person,285.61yuan/person respectively in the Jinchang Cohort.Those indexes of male patients were all higher than those of female.Those indexes of hemorrhagic stroke patients were both higher than those of ischemic stroke patients.The daily hospitalization expenses per capita of hemorrhagic stroke patients was 10562.79 yuan/person,which was 2.13 times of ischemic stroke patients.The average stay length per capita in the workers from the product manufacturing unit was the highest,26.45 day/person.The hospitalization expenses and the daily hospitalization expenses per capita in the workers from mining and mineral processing unit were both the highest,7745.63 yuan/person and 297.91 yuan/day respectively.6.Among the death from stroke of the hospitalized patients,the average stay length,average hospitalization expenses and the average daily hospitalization expenses per capita of stroke patient were 21.09 days/person,9261.69 yuan/person and 439.09 yuan/person respectively in the Jinchang Cohort.Those indexes of male patients were higher than those of female.The average hospital length per capita of ischemic stroke patients was 27.21 days/person,which was higher than that of hemorrhagic stroke patients.The average hospitalization expenses and the average daily hospitalization expenses per capita of hemorrhagic stroke patients were 10668.23 yuan/person and 578.52 yuan /day respectively,which were both higher than those of those of ischemic stroke patients.7.The cumulative survival probability of 30 days,180 days,360 days,720 days,1800 days and 3600 days of stroke patients in Jinchang cohort were 87.86%,85.40%,94.99%,83.39%,80.88 and 77.47% respectively.The risk of death is highest in the first month of hospitalization for stroke patients.The Cox proportional hazards regression model showed that age,gender,type of work unit had nothing to do with the survival time of stroke,only the type of stroke was its influencing factor and that the prognosis of ischemic stroke was better than those of hemorrhagic stroke.Conclusion 1.Stroke is a serious problem on the health of the Jinchang cohort population,people age ? 70 was the high risk group of stroke mortality.2.The disease burden of hemorrhagic stroke was higher than those of that of ischemic stroke,and the male population have a higher disease burden than those of female caused by stroke.3.Among different types of work unit,the smelting chemical unit have the highest PYLL and WPYLL,and the mining and mineral processing unit have the highest direct economic burden caused by stroke.4.The risk of death is highest in the first month of hospitalization for stroke patients.The prognosis of hemorrhagic stroke was worse than those of that of ischemic stroke,and the age,gender and type of unit were not related to the prognosis of stroke.