Stroke Incidence and Outcomes in Indigenous Australians

Background: Aboriginal and Torres Strait Islander (Indigenous) Australians have greater rates of cardiovascular disease-related morbidity and mortality, but there are no prospective population-based studies of stroke incidence in this population. We present the first prospective population-based pilot study of stroke incidence and outcomes in Indigenous Australians. Methods: All suspected strokes in patients from pre-specified postcodes were prospectively assessed across seven hospitals in South Australia and the Northern Territory from 01/10/2015 to 31/12/2015, with three-month follow-up of all cases. Clinical and radiological data were examined to determine stroke type. Results: Of 123 residents with first-ever stroke, 8% identified as Indigenous. The median age of incident stroke was 44 (interquartile range [IQR] 33, 55), 29 years younger than non-Indigenous Australians (73, IQR 62, 84, p&#8197;<&#8197;0.001). Age-standardised stroke incidence was over 3-fold greater in Indigenous than non-Indigenous people (104 vs 33 per 100,000, p&#8197;<&#8197;0.001). In those aged <55 years, stroke incidence was nearly 7-fold greater in Indigenous than non-Indigenous people (95% confidence interval 3–16, p&#8197;<&#8197;0.001). Whilst all traditional stroke risk factors appeared more prevalent in Indigenous Australians, none reached statistical significance. Conclusion: There are marked disparities in stroke incidence and age of onset between Indigenous and non-Indigenous Australians. Our pilot study demonstrates feasibility for a “gold-standard” population-based study, to further explore and address disparities.