Stroke Incidence and Case-Fatality among Indigenous and Non-Indigenous Populations in the Northern Territory of Australia, 1999–2011

Abstract

Background Stroke is a leading cause of death and disability in Australia. The impact of stroke on the Australia Indigenous people is, however, unclear. Aim This study describes hospital-based stroke incidence and case fatality in the Northern Territory population in Australia. Methods Retrospective study of Northern Territory residents with a first-ever stroke episode and case fatality among Northern Territory residents in 1999–2011. Results The rate ratio of age-adjusted stroke incidence between Indigenous and non-Indigenous populations was 2·8 for men and 2·7 for women, similar to those reported elsewhere in Australia. The rate ratio increased to 3·8 (95% confidence interval: 3·4–4·3) after adjusting for multiple risk factors. There was no change in annual incidence between 1999 and 2011 for either non-Indigenous (incidence rate ratio per year 1·01, 95% confidence interval: 1·00–1·03) or Indigenous people (incidence rate ratio: 1·00, 95% confidence interval: 0·98–1·02), although incidence did increase for non-Indigenous people in the 15–39 year age group (incidence rate ratio:1·09, 95% confidence interval:1·02–1·17) and for Indigenous people in the 40–64 year age group (incidence rate ratio:1·03, 95% confidence interva 1·00–1·06). The case fatality rate decreased from 22% in 1999 to 12% in 2011. In-hospital deaths were more common among; older and Indigenous people, for those with other chronic diseases, and from haemorrhagic stroke compared with ischemic stroke. Conclusions In the Northern Territory, as elsewhere in Australia, Indigenous Australians are more likely than other Australians to suffer a stroke. Lack of falling in incidence in the Northern Territory population highlights the importance for ongoing comprehensive primary and acute care in reducing risk factors and managing stroke patients.