Stroke, Vol 24, 1140-1147, Copyright © 1993 by American Heart Association
C Sarti, J Tuomilehto, J Sivenius, E Kaarsalo, EV Narva, K Salmi, V Salomaa and J Torppa
BACKGROUND AND PURPOSE: Our aim was to describe the mortality and early
case-fatality rates of stroke in three geographic areas of Finland during
1983 to 1986 by means of a community-based stroke register and to estimate
the accuracy of registration of stroke deaths in the official statistics
compared with the FINMONICA stroke register. METHODS: Annual and average
mortality and case-fatality rates of stroke were derived from data
collected in the FINMONICA stroke register during 1983 to 1986.
Age-specific and age-standardized rates were calculated for the three
areas, and the results were compared with the official mortality statistics
and with the case-fatality figures published previously in the literature
for Finland and elsewhere. RESULTS: Mortality from stroke in the three
FINMONICA areas was between 73 and 90 per 100,000 per year among men aged
25 to 74 years and between 42 and 55 per 100,000 per year among women in
the same age group. Average case-fatality was similar in the three areas
and globally high: 20% to 27% in men and 24% to 28% in women. Approximately
half of the fatal strokes occurred within less than 2 days from the onset
of the attack, and a further 25% within the first week. Hemorrhagic strokes
accounted for 54% to 81% of all fatal strokes occurring in less than 2 days
among men, while among women the corresponding proportions varied in the
three areas between 35% and 74%. Of cerebral infarctions, approximately 28%
to 37% among men and 19% to 20% among women were fatal within less than 2
days. Although the number of fatal strokes was similar in both the
FINMONICA register and official mortality statistics, only 82% to 85% of
the stroke cases were common in both registers; a further 13% to 14% of the
cases classified as stroke deaths in the FINMONICA register could also be
found in the official mortality statistics, but the underlying cause of
death was something other than stroke. CONCLUSIONS: The reliability of the
Finnish official mortality statistics with regard to stroke deaths is
reasonably good in aggregate numbers, but at the individual level
considerable discrepancies seem to occur. Mortality from stroke in Finland
has not declined further after 1979 and remains high internationally. Early
case-fatality of stroke also seems higher in Finland than in most other
countries. We believe that both the high incidence of stroke and the
severity of the attacks are contributing to mortality and case-fatality
rates of stroke in Finland.
ARTICLES
Stroke mortality and case-fatality rates in three geographic areas of Finland from 1983 to 1986
Department of Epidemiology and Health Promotion, National Public Health Institute of Helsinki, Finland.
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