J Stroke.  2019 Jan;21(1):42-59. 10.5853/jos.2018.03125.

Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society

Affiliations
  • 1Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. braindoc@snu.ac.kr
  • 2Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
  • 3Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Neurology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
  • 5Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 6Department of Neurology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 7Department of Neurology, Eulji University Hospital, Eulji University, Daejeon, Korea.
  • 8Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
  • 9Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
  • 10Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
  • 11Department of Neurology, Seoul Medical Center, Seoul, Korea.
  • 12Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
  • 13Department of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • 14Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 15Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
  • 16Department of Neurology, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.
  • 17Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 18Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 19Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
  • 20Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 21Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
  • 22Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea.
  • 23Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 24Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
  • 25Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.

Abstract

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.

Keyword

Stroke; Statistics; Epidemiology
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