Stroke Incidence

In 2023, stroke incidence recorded in primary care was highest at 172.6 per 100,000, followed by hospital episodes, stroke audit, and death records. Stroke incidence estimates from linked EHRs are likely higher than true rates due to overuse of stroke codes in primary care and difficulty separating first from recurrent events. Age- and sex-standardised stroke incidence rose significantly from 227.6 to 244.8 per 100,000 between 2020 and 2023. During COVID-19 lockdowns, non-fatal stroke recordings fell sharply and stroke-related deaths rose, reflecting changed healthcare-seeking behaviour rather than a true reduction in events. Ischaemic strokes were disproportionately under-recorded during lockdowns, suggesting milder strokes were the most likely to go unrecorded as patients avoided hospital contact.