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In the United States, stroke is the third leading cause of death and one of the major causes of serious, long-term disability among adults. Each year, approximately 500,000 persons suffer a first-time stroke, and approximately 167,000 deaths are stroke-related.1 This report presents national and state-specific death rates for stroke in 1999, which indicate state-by-state variations in both stroke-related death rates and the proportions of stroke decedents who die before transport to an emergency department (ED). Prevention through public and medical education remains a key strategy for reducing stroke-related deaths and disability.
CDC compiled national and state mortality data based on death certificates from state vital statistics offices.2 Demographic data were reported by funeral directors or provided by family members of the decedent. Stroke-related deaths are those for which the underlying cause listed on the death certificate by a physician or a coroner is classified according to the International Classification of Diseases, Tenth Revision (ICD-10) codes I60–I69. Stroke subtypes are defined as subarachnoid hemorrhagic stroke (I60), intracerebral hemorrhagic stroke (I61–I62), ischemic stroke (I63–I67), and sequelae of stroke (I69). Place of death was defined as either pretransport, dead on arrival (DOA), in the ED, or in the hospital after admission. Pretransport deaths occurred at the decedent's residence, in a nursing home, or in an extended-care facility before transport to a hospital or ED. Stroke-related death rates for groups defined by age, sex, race/ethnicity, stroke subtype, and state were determined by dividing the number of deaths by the population at risk in that group. Estimates of resident populations and age-adjusted death rates were calculated by using the 2000 U.S. standard population.3
State-Specific Mortality From Stroke and Distribution of Place of Death—United States, 1999. JAMA. 2002;288(3):309–310. doi:10.1001/jama.288.3.309-JWR0717-2-1
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