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(Stroke. 2006;37:1674.)
© 2006 American Heart Association, Inc.

Original Contributions

Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004

Isabelle Benatru, MD; Olivier Rouaud, MD; Jérôme Durier, PhD; Fabienne Contegal, MD; Grégory Couvreur, MD; Yannick Bejot, MD; Guy Victor Osseby, MD; Douraïeb Ben Salem, MD; Frédéric Ricolfi, MD; Thibault Moreau, MD Maurice Giroud, MD

From the Stroke Registry of Dijon (Inserm and Institut de Veille Sanitaire). Faculty of Medicine and University Hospital of Dijon – France.

Correspondence to M. Giroud, Service de Neurologie, Centre Hospitalo-Universitaire, 3 Rue du Faubourg Raines, 21000 Dijon, France. E-mail maurice.giroud{at}chu-dijon.fr

Background and Purpose— With the progress in stroke prevention, it is important to evaluate the epidemiological trends of strokes over a long period and from a nonselected population-based perspective.

Methods— We estimated changes in incidence, case-fatality rates, severity, risk factors and prestroke use of preventive treatments for first-ever strokes, from a continuous 20-year well-defined population-based registry, from 1985 to 2004.

Results— We recorded 3142 ischemic strokes, 341 primary cerebral hemorrhages and 74 subarachnoid hemorrhages. During the 20-year study, the age at first stroke onset increased by 5 years in men and 8 years in women. Comparing the 1985 to 1989 and the 2000 to 2004 periods, age- and sex-standardized incidences of first-ever strokes were stable except for lacunar strokes whose incidence significantly increased (P=0.01) and for cardioembolic stroke whose incidence significantly decreased (P=0.01). Twenty-eight-day case-fatality rates decreased significantly mainly for lacunar strokes (P=0.05) and for primary cerebral hemorrhages (P=0.03). The proportion of hypercholesterolemia and diabetes significantly increased (P<0.01). In contrast, the proportion of myocardial infarction significantly decreased (P=0.02). Prestroke antiplatelets and anticoagulants treatment significantly increased (P<0.01).

Conclusions— The age- and sex-standardized incidences of first strokes in Dijon have been stable over the past 20 years and were associated with an increase in age at stroke onset, a decrease in case-fatality rates, and an increased use of antiplatelet treatments.

Key Words: cerebrovascular accident • epidemiology • incidence • risk factors • stroke

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