Epidemiology and Health

Special Articles

Incidence and case fatality of stroke in Korea, 2011-2020: Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim; Epidemiol Health. 2024;46:e2024003. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024003

4,909 View
108 Download

Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Stroke remains the second leading cause of death in Korea. This study was designed to estimate the crude, age-adjusted and age-specific incidence rates, as well as the case fatality rate of stroke, in Korea from 2011 to 2020.
METHODS
We utilized data from the National Health Insurance Services from January 1, 2002 to December 31, 2020, to calculate incidence rates and 30-day and 1-year case fatality rates of stroke. Additionally, we determined sex and age-specific incidence rates and computed age-standardized incidence rates by direct standardization to the 2005 population.
RESULTS
The crude incidence rate of stroke hovered around 200 (per 100,000 person-years) from 2011 to 2015, then surged to 218.4 in 2019, before marginally declining to 208.0 in 2020. Conversely, the age-standardized incidence rate consistently decreased by 25% between 2011 and 2020. When stratified by sex, the crude incidence rate increased between 2011 and 2019 for both sexes, followed by a decrease in 2020. Age-standardized incidence rates displayed a downward trend throughout the study period for both sexes. Across all age groups, the 30-day and 1-year case fatality rates of stroke consistently decreased from 2011 to 2019, only to increase in 2020.
CONCLUSIONS
Despite a decrease in the age-standardized incidence rate, the total number of stroke events in Korea continues to rise due to the rapidly aging population. Moreover, 2020 witnessed a decrease in incidence but an increase in case fatality rates.; Summary

Key Message
This nationwide study using Korean National Health Insurance System data reveals a decade-long downward trend in overall stroke incidence rates. While the crude incidence rate showed a temporary increase from 2016 to 2019 before a slight decline in 2020, the age-standardized incidence rate consistently decreased over the study period. The study emphasizes the significance of continuous monitoring and preventive strategies to address stroke as a public health concern in Korea

Incidence and case fatality of acute myocardial infarction in Korea, 2011-2020: Yeeun Seo, Jenny Moon, Hyeok-Hee Lee, Hyeon Chang Kim, Fumie Kaneko, Sojung Shin, Eunji Kim, Jang-Whan Bae, Byeong-Keuk Kim, Seung Jun Lee, Min Kim, Hokyou Lee; Epidemiol Health. 2024;46:e2024002. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024002

4,258 View
103 Download

Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Cardiovascular diseases are a leading cause of mortality worldwide, and acute myocardial infarction (AMI) is particularly fatal condition. We evaluated the incidence and case fatality rates of AMI in Korea from 2011 to 2020.
METHODS
We utilized data from the National Health Insurance Services to calculate crude, age-standardized, and age-specific incidence rates, along with 30-day and 1-year case fatality rates, of AMI from 2011 to 2020. Age-standardized incidence rates were determined using direct standardization to the 2005 population.
RESULTS
The crude incidence rate of AMI per 100,000 person-years consistently increased from 44.7 in 2011 to 68.3 in 2019, before decreasing slightly to 66.2 in 2020. The age-standardized incidence rate of AMI displayed a 19% rise from 2011 to 2019, followed by a slight decline in 2020. The increasing trend for AMI incidence was more pronounced in males than in females. Both 30-day and 1-year case fatality rates remained stable among younger individuals but showed a decrease among older individuals. There was a minor surge in case fatality in 2020, particularly among recurrent AMI cases.
CONCLUSIONS
Over the past decade, the AMI incidence rate in Korea has consistently increased, with a slight downturn in 2020. The case fatality rate has remained relatively stable except for a minor increase in 2020. This study provides data for continuous surveillance, the implementation of targeted interventions, and the advancement of research aimed at AMI in Korea.; Summary

Key Message
This study observed the incidence rate of acute myocardial infarction using data from Korean National Health Insurance Service. From 2011 to 2019, the incidence rate increased, but there was a slight decrease in 2020. Additionally, the fatality rate remained relatively stable throughout the study period, except for an increase in 2020. The study emphasizes the importance of continuous monitoring and preventive strategies for effective management of acute myocardial infarction.

Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in Korea: Minsung Cho, Hyeok-Hee Lee, Jang-Hyun Baek, Kyu Sun Yum, Min Kim, Jang-Whan Bae, Seung-Jun Lee, Byeong-Keuk Kim, Young Ah Kim, JiHyun Yang, Dong Wook Kim, Young Dae Kim, Haeyong Pak, Kyung Won Kim, Sohee Park, Seng Chan You, Hokyou Lee, Hyeon Chang Kim; Epidemiol Health. 2024;46:e2024001. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024001

4,309 View
104 Download
1 Crossref

Abstract Summary PDF

Abstract

OBJECTIVES
The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review.

METHODS

We first established a concept and definition of “hospitalization episode,” taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms’ accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm-identified events.

RESULTS

We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

CONCLUSIONS

We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.

Summary

Key Message
In this study, we developed algorithms to identify acute myocardial infarction (AMI) and stroke events from the Korean National Health insurance Service database. To validate them, we conducted retrospective review of medical records across 24 hospitals throughout Korea. The overall positive predictive values for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

Citations

Citations to this article as recorded by

Incidence and case fatality rates of stroke in Korea, 2011-2020
Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim
Epidemiology and Health.2023; : e2024003. CrossRef

Original Article

Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project: Sung-Ha Lee, Hyeok-Hee Lee, Kiho Sung, Yoosik Youm, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023041. Published online April 4, 2023; DOI: https://doi.org/10.4178/epih.e2023041

5,235 View
187 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults.

METHODS

From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH.

RESULTS

Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the crosssectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02).

CONCLUSIONS

Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.

Summary

Korean summary
본 연구는 “한국인의 사회적 삶, 건강과 노화에 대한 조사”(Korean Social Life, Health and Aging Project, KSHAP)에서 측정한 한 지역 내의 사회적 연결망 자료를 이용하여 사회적 분리와 심혈관 건강 사이의 관계를 살펴보았다. 그 결과, 사회적 분리는 비만, 고혈압, 콜레스테롤, 흡연, 음주 신체적 활동 등을 종합한 ‘라이프 심플 7’ 지표와 부정적인 관련성을 보였으며, 8년 후 추적 조사에서도 이 패턴이 유지되었다. 본 연구 결과는 사회적, 집단적 분리 현상이 신체적 건강에도 악영향을 초래할 수 있음을 시사한다.

Key Message
Using the prospective Korean Social Life, Health, and Aging Project (KSHAP) database, we discovered that group-level segregation was significantly associated with worse cardiovascular health (CVH). Also, we observed a tendency for baseline group-level segregation to be linked to worse CVH after an 8-year follow-up period. These findings emphasize the significance of group-level segregation as a potential contributing factor in the health outcomes of older adults.

Citations

Citations to this article as recorded by

Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey
Shiqi Wang, Hao Zhang, Yiling Lou, Qiqi You, Qingqing Jiang, Shiyi Cao
Journal of Affective Disorders.2024; 349: 577. CrossRef

First
Prev
Page of 1
Next
Last

Search