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(Stroke. 2004;35:1242.)
© 2004 American Heart Association, Inc.

Original Contributions

Effects of Urban Community Intervention on 3-Year Survival and Recurrence After First-Ever Stroke

Bin Jiang, MD, MPH; Wen-zhi Wang, MD; Sheng-ping Wu, MD; Xiao-li Du, MD Qiu-ju Bao, MD

From Beijing Neurosurgical Institute, Beijing, People’s Republic of China.

Correspondence to Dr Bin Jiang, Department of Neuroepidemiology, Beijing Neurosurgical Institute, 6 Tiantan Xili, Yongnei Street, Chongwen District, Beijing 100050, PR China. E-mail bjyjiang{at}hotmail.com

Background and Purpose— For the past 2 decades, stroke has been a principal cause of death in China, and stroke incidence tends to increase with the increase of stroke-related risk factors. The purpose of this study was to evaluate the effects of urban community-based intervention on 3-year survival and recurrence after first-ever stroke.

Methods— Two communities with a registered population of 50 000 each were selected as either intervention or control communities in Beijing during 1991 to 2000. Comprehensive intervention measures including the management of high-risk population and the health education of whole community population were regularly implemented. Then the influence of community intervention on 3-year survival and recurrence after initial stroke was evaluated.

Results— Within 3 years, 41.85% of 736 patients in the intervention community died whereas 40.34% of 818 patients in the control community died. Of 223 cases from the intervention community, 26 (11.66%) had a recurrent stroke within 3 years versus 52 (20.80%) of 250 cases from the control community. The statistical difference was found. Compared with the control community, the death risk of first-ever stroke in the intervention community decreased by 26% (relative risk [RR]=0.74; 95% confidence interval [CI]: 0.61 to 0.89; P=0.002); especially, that of hemorrhagic stroke decreased by 39% (RR=0.61; 95%CI: 0.46 to 0.81; P=0.001). Compared with the control community, the recurrence risk of first-ever stroke from the intervention community decreased by 42% (RR=0.58; 95% CI: 0.34 to 1.00; P=0.048).

Conclusion— Community intervention may be effective and beneficial to the recurrence prevention and survival improvement of stroke, especially hemorrhagic stroke.

Key Words: stroke • epidemiology • mortality • recurrence

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