• Deepak Darshan, Nisal Gange, Daniel Chen, and Anthony Bragg.
• Metro North Hospital and Health Service (MNHHS), Internal Medicine Services, Queensland Health, Brisbane, Queensland, Australia.
• Intern Med J. 2023 Sep 1; 53 (9): 161816241618-1624.

BackgroundStroke rates globally have been declining, but a majority of the studies on strokes have been in urban populations. Regional populations have been understudied, bgeographic health differentials can impact stroke presentations and outcomes.AimTo determine the incidence, risk factors for and survivability of stroke in patients presenting to a large rural stroke referral centre.MethodsData were collected from one major regional stroke referral centre in Queensland, Australia, over 12 months with follow-up at 3.75 years for survival analysis. Patients were retrospectively enrolled based on a diagnosis made by a stroke physician. ICD-10 codes at separation and postcode of residence were applied for case ascertainment. Trial of ORG10172 in Acute Stroke Treatment (TOAST) classification and the World Health Organization  standardised definition of stroke were applied.ResultsThere were 105 strokes in a population of 106 760 persons over 12 months, giving a crude rate of 98 per 100 000 and standardised rate of 52/100 000 per year. Cardioembolism (n = 33, 31.4%) was the most common cause out of all ischaemic strokes (n = 87, 82.9%), followed by large vessel atherosclerosis (n = 26, 24.8%). Hypertension was the most prevalent risk factor in all stroke types, and atrial arrhythmia was the most prevalent factor in cardioembolic strokes. Overall survival at 3.75 years was 61%.ConclusionsIncidence of stroke in a regional Queensland population is similar to other regional populations and when compared with larger cities. Despite a global trend in stroke reduction, modifiable risk factors like hypertension and atrial arrhythmias continue to be over-represented in the stroke population. All-cause mortality after stroke is high, especially during the initial period.© 2022 Royal Australasian College of Physicians.

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