(Stroke. 1997;28:2500-2506.)
© 1997 American Heart Association, Inc.
Articles |
High Stroke Incidence in the Prospective Community-Based L'Aquila Registry (1994–1998)
First Year's Results
From the Institutes of Neurology (A.C., C.M., M. Di N., G. Di G., P.S., M.B., G. De M.) and Clinical Epidemiology (F. di O.), Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila-Collemaggio, Italy.
Background and Purpose Changes in stroke incidence are likely to occur as a consequence of aging of the population, but evidence for this hypothesis is lacking.
Methods A prospective community-based registry of first-ever strokes (1994 to 1998) classified according to the International Classification of Diseases, 9th Revision (ICD-9) was established in the L'Aquila district, central Italy, with a total population of 297 838 (1991 census). Patients were identified by active monitoring of multiple sources, including general practitioners.
Results In 1994, 819 patients (398 men and 421 women; mean±SD age, 74.8±11.3 years) suffered from a first-ever stroke. Eighty-nine percent of the patients had neuroimaging studies of the brain and were reclassified with the recent Application of the International Classification of Diseases to Neurology (ICD-10 NA). The occurrence of subarachnoid hemorrhage, intracerebral hemorrhage, cerebral infarction, and ill-defined events was 2.9%, 14.9%, 80.2%, and 2.0%, respectively. Crude annual incidence of first-ever stroke was 2.75/1000 (95% confidence interval [CI], 2.57 to 2.94) and 24.23/1000 (95% CI, 21.65 to 27.10) in patients older than 80 years. Incidence rates were higher in men and steeply increased with age. The standardized rate was 2.37/1000 for the Italian and 2.28/1000 for the European population. The 30-day case-fatality rate was 25.6% (95% CI, 22.8% to 28.7%). The occurrence of death, disability, and full recovery at 1 year was 36.9%, 38.9%, and 24.2%, respectively. No differences were found in stroke incidence and case-fatality according to income and urban or rural residences.
Conclusions In our population-based study, we found a high stroke incidence notably in the older age subgroups, suggesting that rather than declining, stroke is only being postponed until later in life.
Key Words: aging • cerebral infarction • incidence • intracerebral hemorrhage • registries • subarachnoid hemorrhage
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