The burden of stroke has been increasing in France for several years, due to the aging of the French population, improved survival after ischemic stroke, but also to the rising incidence of stroke in adults under the age of 65.

The aim of this study was to describe the epidemiology, management and prognosis of strokes identified by the Système National des Données de Santé (SNDS), almost ten years after the first national stroke plan (2010–2014).

Patients ≥ 18 years of age hospitalized for stroke in 2022 were identified from medico-administrative data. Stroke prevalence at January 1, 2023 was defined as the number of people alive at that date with a history of hospitalization for stroke or a long-term condition for this disease (2012–2022). Incidence and prevalence rates per 100,000 inhabitants were calculated using population data from French national statistics. Managment durinig the hospitalization was recorded. Patients were followed up for up to one year after hospitalization for stroke, to record vital status, rates of admission to medical and rehabilitation care (SMR), post-stroke consultation with a neurologist, and drug treatment.

In 2022, 122,422 adults were hospitalized at least once for stroke, stroke prevalence was estimated at 1,086,795 cases and 30,682 adults died of stroke (Figure 1). Significant social and territorial inequalities in the incidence of stroke were observed in France. The mean and median duration of hospitalization was 12.5 and 8.0 days respectively. Atrial fibrillation, hypertension and diabetes were the most frequent risk factors associated with stroke. Mechanical thrombectomy was performed in 7.2% of ischemic strokes. Admission to a stroke unit was found in 46.8% of patients, with significant variations according to department, age and gender. Among survivors at 6 months, follow-up showed an admission rate to stroke rehabilitation of 34.3% for ischemic strokes and 41.7% for hemorrhagic strokes; 28.8% and 18.8% of ischemic and hemorrhagic strokes respectively had been seen by a neurologist, and 19.5% of ischemic strokes were seen by a cardiologist within 6 months. Case fatality at 1 year was 20.8% of patients hospitalized for ischemic stroke and 37.9% of those hospitalized for hemorrhagic stroke.

The burden of stroke in France is very high with social and territorial inequalities.These results call for more effective prevention of stroke before and after the acute phase.