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Geographic Variation in One-Year Recurrent Ischemic Stroke Rates for Elderly Medicare Beneficiaries in the USA
Norrina B. Allen, Theodore R. Holford, Michael B. Bracken, Larry B. Goldstein, George Howard, Yun Wang, Judith H. Lichtman. Neuroepidemiology, 2010-01-01
Topic: Risk, prevention and care in population studies
The overall 1-year recurrent stroke rate was 9.4% among 895,916 ischemic stroke patients (mean age: 78 years; 56.6% women; 86.6% White, 9.7% Black and 1.2% Latino/Hispanic). The rates varied by geographic region and were highest in the South and in parts of the West and Midwest. Regional variation was present for all racial/ethnic subgroups and persisted after adjustment for individual patient characteristics. Almost 1 in 10 hospitalized ischemic stroke patients was readmitted for an ischemic stroke within 1 year. There was heterogeneity in recurrence patterns by geographic region. Further work is needed to understand the reasons for this regional variability.
Key findings
- The overall 1-year recurrent stroke rate was 9.4% among 895,916 ischemic stroke patients (mean age: 78 years; 56.6% women; 86.6% White, 9.7% Black and 1.2% Latino/Hispanic).
- The rates varied by geographic region and were highest in the South and in parts of the West and Midwest.
- Regional variation was present for all racial/ethnic subgroups and persisted after adjustment for individual patient characteristics.
- Almost 1 in 10 hospitalized ischemic stroke patients was readmitted for an ischemic stroke within 1 year.
- There was heterogeneity in recurrence patterns by geographic region.
Why it matters
This study found that one-year recurrent ischemic stroke rates in elderly Medicare beneficiaries varied by geographic region and were highest in the South and parts of the West and Midwest. It does not test a dementia treatment or prevention, so it cannot show how to cure or prevent dementia.
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Study details
- Effect size9.4%; 56.6%; 86.6%
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Neuroepidemiology) |
| Journal's citation record | 1 / 4 | Neuroepidemiology: journal h-index 125 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 54 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.0 citations a year over 18 year(s) since 2010 |
| Impact for its field and year | 3 / 6 | Cited 4.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Judith H. Lichtman: h-index 76 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Yale University: institution h-index 1,927 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20068358) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Allen, N. B., Holford, T. R., Bracken, M. B., Goldstein, L. B., Howard, G., Wang, Y., et al. (2010). Geographic Variation in One-Year Recurrent Ischemic Stroke Rates for Elderly Medicare Beneficiaries in the USA. Neuroepidemiology. https://doi.org/10.1159/000274804
Vancouver
Allen NB, Holford TR, Bracken MB, Goldstein LB, Howard G, Wang Y, et al. Geographic Variation in One-Year Recurrent Ischemic Stroke Rates for Elderly Medicare Beneficiaries in the USA. Neuroepidemiology. 2010. doi:10.1159/000274804. PMID: 20068358.
BibTeX
@article{allen2010-20068358,
author = {Allen, Norrina B. and Holford, Theodore R. and Bracken, Michael B. and Goldstein, Larry B. and Howard, George and Wang, Yun and Lichtman, Judith H.},
title = {{Geographic Variation in One-Year Recurrent Ischemic Stroke Rates for Elderly Medicare Beneficiaries in the USA}},
journal = {Neuroepidemiology},
year = {2010},
doi = {10.1159/000274804},
pmid = {20068358},
url = {https://doi.org/10.1159/000274804}
}