UK Stroke Forum 2025 | The revised ICD-11 definition of stroke: impact on incidence and outcomes

So, before 2022, stroke was defined as clinical, rapidly evolving symptoms that lasted for more than 24 hours or until the death of the patient. However, since 2022, this definition changed. And this regarding the duration of the symptoms, if you have a scan that shows that you have a stroke, you have a stroke, so with these we wanted to estimate how much this will raise stroke incidence or modify it at all. So we analyzed data on two years on the South London Stroke Register from April 2022 to April 2024. And we found out that stroke incidence was increased by 7%. More importantly, we found that these patients were having a different profile. So they were most likely to be young. They were most likely to be male and to have milder strokes, meaning an NIHSS of lower than five. They were all 100% identified by MRI. And on the outcomes, they had several recurrences and they had better cognitive and functional outcomes at three months. The recurrence was also at three months. So this paper has some important insights. First, it highlights the importance of doing MRIs on milder strokes because it identifies strokes that were before diagnosed as TIAs. And second, it also creates the need to analyze how this change of definition will impact the costs of stroke, not only here in the NHS but also worldwide, because these people having these newly identified strokes might not require stroke units but they might be managed in ambulatory care. So we need to invest in MRIs and prioritize ambulatory care for managing these newly identified subtypes of strokes.

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