1Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea
2Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
3Medical AI Co., Ltd., Seoul, Republic of Korea
4Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
5Central Division of Cardio-cerebrovascular Disease Management, Seoul National University Hospital, Seoul, Republic of Korea
6Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
7Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
8Department of Cardiology, Chosun University Hospital, Gwangju, Republic of Korea
9Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
10Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
11Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
12Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
13Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
14Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Seoul, Republic of Korea
15Department of Neurology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
© 2024 Korea Disease Control and Prevention Agency.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Ethics Approval
The Institutional Review Board (IRB) of Seoul National University (IRB No: E-2104-135-1213, E-2109-031-1252, and H-2106-064-1225) approved this study. Additionally, the requirement for informed consent was waived by the IRB because of the retrospective nature of this study.
Conflicts of Interest
The authors have no conflicts of interest to declare.
Funding
This work was funded by the Korean Disease Control and Prevention Agency.
Availability of Data
All data analyzed during this study are included in this published article. While the datasets are not publicly available, inquiries regarding access to the study data can be directed to the corresponding authors. All authors read and approved the final manuscript.
Authors’ Contributions
Conceptualization: HJK, JoL, HJB; Data curation: SEK, JP, JES, JiL; Formal analysis: TJK, HSL, SEK, JP, JES, JiL; Funding acquisition: HJB; Investigation: TJK, HSL, SEK, JYK, JP, JES, JiL; Methodology: TJK, HSL, SEK, JYK, JiL, JHC, HCK, DHS, HYL, BJK, WKS, JMP, SJL, KHJ; Project administration: JHH, JP, JoL, KH, HJK, HJB; Software: SEK, JP, JES, JiL; Supervision: HJK, SUK, YCH, HSK, JuL, HJB; Validation: TJK, HSL, SEK, JYK, JP, JES, JiL; Visualization: TJK, SEK, JP; Writing–original draft: TJK, HJB; Writing–review & editing: all authors.
Additional Contributions
We wish to extend our sincere gratitude to the National Health Insurance Service and the Health Insurance Review and Assessment Service for their valuable contribution in providing the data for our research.
Variable | Stroke | AMI |
---|---|---|
Total incident cases | 150,837 | 40,529 |
Total patients | 131,347 | 39,720 |
Incidence rate | ||
Total (cases/100,000 person-year) (95% CI) | ||
Crude incidence rate | 294.9 (293.4–296.4) | 79.2 (78.5–80.0) |
Age, sex-standardized incidence ratea) | 180.2 (178.3–182.2) | 46.1 (45.1–47.0) |
Age-standardized incidence rateb) | 175.6 (174.6–176.5) | 46.0 (45.5–46.4) |
Male (cases/100,000 person-year) (95% CI) | ||
Crude incidence rate | 329.1 (326.9–331.3) | 106.0 (104.8–107.3) |
Age-standardized incidence rate) | 196.3 (194.9–197.8) | 62.2 (61.4–63.0) |
Female (cases/100,000 person-year) (95% CI) | ||
Crude incidence rate | 260.8 (258.9–262.8) | 52.6 (51.7–53.5) |
Age-standardized incidence ratea) | 164.0 (162.7–165.4) | 29.9 (29.3–30.3) |
Incidence proportion | ||
Total (cases/100,000 people) (95% CI) | ||
Crude incidence proportion | 256.0 (254.6–257.4) | 77.4 (76.7–78.2) |
Age, sex-standardized incidence proportiona) | 154.1 (152.3–155.9) | 44.4 (43.5–45.3) |
Age-standardized incidence proportionb) | 149.1 (147.1–151.1) | 44.2 (43.8–44.7) |
Male (cases/100,000 people) (95% CI) | ||
Crude incidence proportion | 283.0 (280.9–285.0) | 103.7 (102.5–105.0) |
Age-standardized incidence proportiona) | 166.4 (165.1–167.7) | 60.2 (59.4–60.9) |
Female (cases/100,000 people) | ||
Crude incidence proportion | 229.2 (227.3–231.0) | 51.2 (50.4–52.1) |
Age-standardized incidence proportiona) | 141.7 (130.5–142.9) | 28.6 (28.1–29.1) |
Total centers | Stroke | Not a stroke | Total | AMI | Not an AMI | Total |
---|---|---|---|---|---|---|
Total cases | 578 | 508 | 1,086 | 520 | 594 | 1,114 |
Algorithm-positive with the ICD codes | 545 | 58 | 603 | 509 | 59 | 568 |
Algorithm-negative with the ICD codes | 33 | 21 | 54 | 11 | 49 | 60 |
Algorithm-negative without the ICD codes | 0 | 429 | 429 | 0 | 486 | 486 |
Cases in the capital region | ||||||
Tertiary hospitals | 128 | 88 | 216 | 117 | 160 | 277 |
Algorithm-positive with the ICD codes | 121 | 29 | 150 | 116 | 24 | 150 |
Algorithm-negative with the ICD codes | 7 | 6 | 13 | 1 | 14 | 15 |
Algorithm-negative without the ICD codes | 0 | 53 | 53 | 0 | 112 | 112 |
General hospitals | 111 | 173 | 284 | 124 | 131 | 255 |
Algorithm-positive with the ICD codes | 108 | 15 | 123 | 123 | 12 | 135 |
Algorithm-negative with the ICD codes | 3 | 8 | 11 | 1 | 11 | 12 |
Algorithm-negative without the ICD codes | 0 | 150 | 150 | 0 | 108 | 108 |
Cases in non-capital regions | ||||||
Tertiary hospitals | 175 | 130 | 305 | 151 | 159 | 310 |
Algorithm-positive with the ICD codes | 163 | 4 | 167 | 145 | 5 | 150 |
Algorithm-negative with the ICD codes | 12 | 3 | 15 | 6 | 14 | 20 |
Algorithm-negative without the ICD codes | 0 | 123 | 123 | 0 | 140 | 140 |
Non-capital regions | ||||||
General hospitals | 144 | 97 | 241 | 116 | 132 | 248 |
Algorithm-positive with the ICD codes | 135 | 8 | 143 | 114 | 7 | 121 |
Algorithm-negative with the ICD codes | 9 | 4 | 13 | 2 | 10 | 12 |
Algorithm-negative without the ICD codes | 0 | 85 | 85 | 0 | 115 | 115 |
Hospitals | 20 | 20 | 40 | 12 | 12 | 24 |
Algorithm-positive with the ICD codes | 18 | 2 | 20 | 11 | 1 | 12 |
Algorithm-negative with the ICD codes | 2 | 0 | 2 | 1 | 0 | 1 |
Algorithm-negative without the ICD codes | 0 | 18 | 18 | 0 | 11 | 11 |
Variable | Total (n=1,086) | Stroke (n=578) | Not a stroke (n=508) | p |
---|---|---|---|---|
Age (y) | 64.9±19.0 | 72.3±11.9 | 56.5±21.9 | <0.001 |
Male | 560 (51.6) | 300 (51.9) | 260 (51.2) | 0.81 |
Admission routes | <0.001 | |||
Direct visit | 537 (49.4) | 471 (81.5) | 66 (13.0) | |
During hospitalization | 6 (0.6) | 6 (1.0) | 0 (0.0) | |
Transfer | 97 (8.9) | 85 (14.7) | 12 (2.4) | |
Unknown | 446 (41.1) | 16 (2.8) | 430 (84.6) | |
Type of stroke | <0.001 | |||
No stroke | 508 (46.8) | 0 (0) | 508 (100.0) | |
Ischemic stroke | 511 (47.0) | 511 (88.4) | 0 (0) | |
Hemorrhagic stroke | 67 (6.2) | 67 (11.6) | 0 (0) | |
History of MI | 15 (1.4) | 15 (2.6) | 0 (0) | 0.39 |
History of stroke | 168 (15.5) | 130 (22.5) | 38 (7.5) | <0.001 |
In-hospital mortality | 38 (3.5) | 36 (6.2) | 2 (0.4) | <0.001 |
Variable | Total (n=1,114) | AMI (n=520) | Not an AMI (n=594) | p |
---|---|---|---|---|
Age (y) | 61.3±21.7 | 70.7±10.9 | 53.0±25.1 | <0.001 |
Male | 691 (62.0) | 378 (72.7) | 313 (52.7) | <0.001 |
Admission routes | <0.001 | |||
Direct visit | 484 (43.5) | 408 (78.5) | 76 (12.8) | |
During hospitalization | 15 (1.35) | 13 (2.5) | 2 (0.3) | |
Transfer | 107 (9.6) | 99 (19.0) | 8 (1.3) | |
Unknown | 508 (45.6) | 0 (0.0) | 508 (85.5) | |
Chest pain | 448 (40.2) | 409 (78.7) | 39 (6.6) | |
Serum troponin I or T test | 715 (64.2) | 518 (99.6) | 197 (33.2) | <0.001 |
ECG | 609 (54.7) | 518 (99.6) | 91 (15.3) | <0.001 |
CAG | 586 (52.6) | 512 (98.5) | 74 (12.5) | <0.001 |
History of MI | 79 (7.1) | 47 (9.0) | 32 (5.4) | 0.001 |
History of angina | 43 (3.9) | 36 (6.9) | 7 (1.2) | <0.001 |
In-hospital mortality | 42 (3.8) | 33 (6.3) | 9 (1.5) | <0.001 |
Region | Hospital | PPV (%) | NPV1 (%) | NPV2 (%) |
---|---|---|---|---|
Stroke | ||||
Capital region | Tertiary hospital | 80.7 | 53.3 | 100 |
General hospital | 87.8 | 69.4 | 100 | |
Non-capital region | Tertiary hospital | 97.6 | 20.0 | 100 |
General hospital | 94.4 | 31.2 | 100 | |
Other hospital | 90.0 | 0 | 100 | |
AMI | ||||
Capital region | Tertiary hospital | 77.3 | 95.0 | 100 |
General hospital | 91.1 | 91.7 | 100 | |
Non-capital region | Tertiary hospital | 96.7 | 80.0 | 100 |
General hospital | 94.2 | 83.3 | 100 | |
Other hospital | 91.7 | 0 | 100 |
Variable | Stroke | AMI |
---|---|---|
Total incident cases | 150,837 | 40,529 |
Total patients | 131,347 | 39,720 |
Incidence rate | ||
Total (cases/100,000 person-year) (95% CI) | ||
Crude incidence rate | 294.9 (293.4–296.4) | 79.2 (78.5–80.0) |
Age, sex-standardized incidence rate |
180.2 (178.3–182.2) | 46.1 (45.1–47.0) |
Age-standardized incidence rate |
175.6 (174.6–176.5) | 46.0 (45.5–46.4) |
Male (cases/100,000 person-year) (95% CI) | ||
Crude incidence rate | 329.1 (326.9–331.3) | 106.0 (104.8–107.3) |
Age-standardized incidence rate) | 196.3 (194.9–197.8) | 62.2 (61.4–63.0) |
Female (cases/100,000 person-year) (95% CI) | ||
Crude incidence rate | 260.8 (258.9–262.8) | 52.6 (51.7–53.5) |
Age-standardized incidence rate |
164.0 (162.7–165.4) | 29.9 (29.3–30.3) |
Incidence proportion | ||
Total (cases/100,000 people) (95% CI) | ||
Crude incidence proportion | 256.0 (254.6–257.4) | 77.4 (76.7–78.2) |
Age, sex-standardized incidence proportion |
154.1 (152.3–155.9) | 44.4 (43.5–45.3) |
Age-standardized incidence proportion |
149.1 (147.1–151.1) | 44.2 (43.8–44.7) |
Male (cases/100,000 people) (95% CI) | ||
Crude incidence proportion | 283.0 (280.9–285.0) | 103.7 (102.5–105.0) |
Age-standardized incidence proportion |
166.4 (165.1–167.7) | 60.2 (59.4–60.9) |
Female (cases/100,000 people) | ||
Crude incidence proportion | 229.2 (227.3–231.0) | 51.2 (50.4–52.1) |
Age-standardized incidence proportion |
141.7 (130.5–142.9) | 28.6 (28.1–29.1) |
AMI, acute myocardial infarction; ICD, International Classification of Diseases.
Data are presented as mean±standard deviation or MI, myocardial infarction.
Data are presented as mean±standard deviation or AMI, acute myocardial infarction; ECG, electrocardiogram; CAG, coronary angiography; MI, myocardial infarction.
AMI, acute myocardial infarction; PPV, positive predictive value; NPV, negative predictive value.
AMI, myocardial infarction; CI, confidence interval. 2005 Mid-year population in the Republic of Korea. 2000 World Health Organization standard population.