(Stroke. 1998;29:2501-2506.)
© 1998 American Heart Association, Inc.
Original Contributions |
A Prospective Community-Based Study of Stroke in Germany—The Erlangen Stroke Project (ESPro)
Incidence and Case Fatality at 1, 3, and 12 Months
From the Departments of Neurology (P.L.K.-R., P.U.H., C.G., S.S., B.N.) and Medical Statistics (A.K.), Friedrich-Alexander Universitaet Erlangen–Nuremberg, Erlangen, Bavaria, Germany; the Department of Epidemiology and Public Health Promotion (C.S.), National Public Health Institute, Helsinki, Finland; the Departments of Medicine (E.L.) and Geriatric Medicine (K.-G.G.), Waldkrankenhaus St. Marien, Erlangen, Germany; and the Department of Neurological Rehabilitation (T.R.v S.), Klinikum am Europakanal, Erlangen, Germany.
Background and Purpose—In Germany, basic data on stroke morbidity are lacking. If a population-based register in former East Germany is excluded, only routine mortality statistics have thus far provided information on epidemiology of stroke. Therefore, a population-based register of stroke was set up in Southern Germany to determine incidence and case fatality in a defined German population.
Methods—The Erlangen Stroke Project (ESPro) is a prospective community-based study among the 101 450 residents of the city of Erlangen, Bavaria, Germany. Standard definitions and overlapping case-finding methods were used to identify all cases of first-ever stroke in all age-groups, occurring in the 2 years of registration (April 1, 1994, to March 31, 1996). All identified cases of first-ever strokes were followed up at 3 and 12 months from onset.
Results—During 2 years of registration, 354
first-ever-in-a-lifetime strokes (FELS) were registered. The diagnosis
and stroke type were confirmed by CT scan in 95% of cases. Fifty-one
percent of all FELS occurred in the age group 
75 years of age. The
crude annual incidence rate was 1.74 per 1000 (1.47 for men and 2.01
for women). After age-adjustment to the European population, the
incidence rate was 1.34 per 1000 (1.48 for men and 1.25 for women). The
annual crude incidence rate of cerebral infarction was 1.37/1000,
intracerebral hemorrhage 0.24/1000,
subarachnoid hemorrhage 0.06/1000, and unspecified
stroke 0.08/1000. Overall case fatality at 28 days was 19.4%, at 3
months it was 28.5%, and at 1 year 37.3%.
Conclusions—The first prospective community-based stroke register including all age groups in Germany revealed incidence rates of stroke similar to those reported from other population-based studies in western industrialized countries, but lower than that observed in former East Germany.
Key Words: epidemiology • Germany • incidence • mortality • prognosis
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