Geographic Information System of Stroke Incidence in Zanjan Province, Iran During 2012-2019

Abstract: Background and Objective: Stroke is the second leading cause of mortality and the third leading cause of morbidity worldwide. This study aimed to examine the spatial-temporal distribution of stroke in rural districts, Zanjan Province, Iran. Materials and Methods: This cross-sectional study was conducted at Zanjan University of Medical Sciences (ZUMS). Patients with a discharge diagnosis of stroke (the ICD-10 code of I64), hospitalized during 2012-2019 at ZUMS hospitals, were selected as the study sample. Spatial statistical tools, autocorrelation Moran’s I, high-low clustering analysis, and hot spot analysis were used for spatial data analysis. ArcGIS 10.7, R 3.6.0, and RStudio 1.2.1335 software packages were used to analyze the data. Results: During 2012-2019, 8404 stroke cases were hospitalized at ZUMS hospitals, with an incidence of 697 patients per 100 000 people. Men had a higher rate of stroke incidence (52.06%) compared with women (47.94%). The mean age of patients was 69.3±14.7 years; the mean length of stay was 158.8±270 hours. In the study area, 4 significantly hot spot areas and 4 low-high outliers of stroke were found. Conclusion: This study showed a high incidence of stroke in Zanjan Province, Iran, from 2012 to 2019. Identifying high-risk areas of stroke is a warning to healthcare authorities and policymakers to focus on major risk factors. It can help to figure out the possible causes of stroke and implement prevention programs to reduce stroke incidence in these areas. Keywords: Cardiovascular diseases, Epidemiology, Geographic information systems, Strok