Hospitalized Strokes
Lower rates are desirable.
(Total number of new stroke events for persons age 18 and older ÷ Total mid-year population age 18 and older) × 100,000 (Age-adjusted)
Unit of Analysis: Single admission
Total mid-year population age 18 and older
Cases that are new stroke events admitted to an acute care hospital, age 18 and older
A new event is defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.
Methodology
Name
Hospitalized Strokes
Short/Other Names
Hospitalized Stroke Event
Description
This indicator measures the age-standardized rate of new stroke events admitted to an acute care hospital for the Canadian population age 18 and older. A new event is defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.
For further details, please see the General Methodology Notes (PDF).
Rationale
Stroke is one of the leading causes of long-term disability and death. Measuring its occurrence in the population is important for planning and evaluating preventive strategies, allocating health resources and estimating costs. From a disease surveillance perspective, there are three groups of strokes: fatal events occurring out of the hospital, non-fatal strokes managed outside acute care hospitals and non-fatal strokes admitted to an acute care facility. Although strokes admitted to a hospital do not reflect all stroke events in the community, this information provides a useful and timely estimate of the disease occurrence in the population.
Interpretation
Lower rates are desirable.
HSP Framework Dimension
Health system outcomes: Improve health status of Canadians
Areas of Need
Not applicable
Targets/Benchmarks
Not applicable
Available Data Years
to (fiscal years)
Geographic Coverage
- All provinces/territories except Quebec
Reporting Level/Disaggregation
- National
- Province/Territory
- Region
- Neighbourhood Income Quintile
Indicator Results
Update Frequency
Every year
Latest Results Update Date
Updates
Beginning with rates based on 2015–2016 data, ICD-10-CA codes used to identify stroke cases have been updated as a result of consultation and close collaboration with the Heart and Stroke Foundation and the Public Health Agency of Canada. Specifically, ICD-10-CA code I62 was excluded from stroke case selection, and H34.1, I67.6 and G08 were added under their respective subcategories. These changes have no substantial impact on comparisons with previously reported results.
Description
(Total number of new stroke events for persons age 18 and older ÷ Total mid-year population age 18 and older) × 100,000 (Age-adjusted)
Unit of Analysis: Single admission
Type of Measurement
Rate - per 100,000
Denominator
Description:
Total mid-year population age 18 and older
Numerator
Description:
Cases that are new stroke events admitted to an acute care hospital, age 18 and older
A new event is defined as a first-ever hospitalization for stroke or a recurrent hospitalized stroke occurring more than 28 days after the admission for the previous event in the reference period.
Inclusions:
- Stroke present on admission (per codes specified below — coded as diagnosis type (1) or [type (M), (W), (X) or (Y), but not also as diagnosis type (2)] Stroke diagnosis codes:
- Subarachnoid hemorrhage (ICD-10-CA: I60)
- Intracerebral hemorrhage (ICD-10-CA: I61, I62.9 [for data years prior to 2015–2016*])
- Ischemic stroke (ICD-10-CA: I63.0–I63.5, I63.8, I63.9, H34.1)
- Stroke, not specified as hemorrhage or infarction (ICD-10-CA: I64)
- Venous sinus/cortical vein thrombosis (ICD-10-CA: I63.6, I67.6, G08)
Notes
*I62.9 was used for coding hemorrhagic stroke not otherwise specified in fiscal years prior to 2015–2016. As of 2015–2016, this condition is coded to I61.9 Intracerebral haemorrhage, unspecified.
Transient ischemic attacks are not included in this indicator.
- Age at admission 18 years and older
- Sex recorded as male or female
- Admission to an acute care institution (Facility Type Code = 1)
Exclusions:
- Records with an invalid health card number
- Records with an invalid code for province issuing health card number
- Records with an invalid admission date
- Cadaveric donor or stillbirth records (Admission Category Code = R or S)
- Stroke admissions within 28 days after the admission date of the previous stroke hospitalization
- Patients with medical assistance in dying (MAID) (Discharge Disposition Code = 73)
Method of Adjustment
Direct standardization
Standard Population
Canada 2011
Adjustment Applied
Age-adjusted
Geographic Assignment
Place of residence
Data Sources
- DAD
Caveats and Limitations
Not applicable
Trending Issues
Not applicable
References
Heart and Stroke Foundation of Canada. The Growing Burden of Heart Disease and Stroke in Canada 2003. Available at http://publications.gc.ca/collections/Collection/H1-10-2003E.pdf. Accessed August 23, 2024.
Johansen HL et al. Incidence, Comorbidity, Case Fatality and Readmission of Hospitalized Stroke Patients in Canada. Canadian Journal of Cardiology. 2006; 22: 65-71.
Truelsen T, Bonita R and Jamozik K. Suveillance of Stroke: A Global Perspective. International Journal of Epidemiology. 2001;30:S11-S16.
World Health Organization. WHO STEPS Stroke Manual: The WHO STEPwise Approach to Stroke Surveillance. Geneva, Switzerland: WHO, 2006.
How to cite:
Canadian Institute for Health Information. Hospitalized Strokes . Accessed April 25, 2025.
If you would like CIHI information in a different format, visit our Accessibility page.
Comments
This indicator includes all new hospitalized stroke events in the reference period, encompassing first-ever and recurrent strokes. A person may have more than one stroke event in the reference period. Stroke events not admitted to an acute care hospital and in-hospital strokes are not included in this indicator.
Note that it is not possible to identify strokes resulting from occlusion of pre-cerebral arteries in the ICD-9 coding system; these strokes are included in this indicator.
Rates for Quebec are not available due to differences in data collection.
Indicator results are also available on