This national study estimated excess stroke deaths (ICD-10 I60-I69) across Japan's 47 prefectures in 2020-2022. Poisson models with a spline for calendar time projected expected deaths from 2014-2019 baselines, by prefecture, sex and age. Japan recorded 3,434 excess stroke deaths (95% CI 2,366-4,503), or 0.93 per 100,000, with 3,248 in males. Excess rates were 7.15 per 100,000 at ages 70-79 and 3.44 at 80 and over. Almost all the excess emerged in 2022. Twenty prefectures showed significant excesses and 16 showed deficits. The estimate depended on the assumed pre-pandemic trend, and the associations do not establish causation.
Why it is interesting: Stroke mortality had already stopped falling before the pandemic, so the choice of baseline drives any excess estimate. The excess appeared only in 2022, not in the first two pandemic years.
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