Published Online
on October 7, 2004

A more recent version of this article appeared on November 1, 2004

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Submitted on March 2, 2004
Revised on August 7, 2004
Accepted on August 12, 2004

Stroke Incidence and 30-Day Case-Fatality in a Suburb of Tbilisi. Results of the First Prospective Population-Based Study in Georgia

Alexander Tsiskaridze MD; Mamuka Djibuti MD; Guy van Melle PhD; Giorgi Lomidze MD; Sophia Apridonidze MD; Iana Gauarashvili MD; Bartomiej Piechowski-Jówiak MD; Roman Shakarishvili MD; and Julien Bogousslavsky MD^*

From the Department of Neurology (A.T., B.P.-J., J.B.), CHUV, Lausanne, Switzerland; the Sarajishvili Institute of Neurology and Neurosurgery (A.T., G.L., S.A., I.G., R.S.), Tbilisi, Georgia; the Department of Public Health and Epidemiology (M.D.), Georgian State Medical Academy Tbilisi, Georgia; and the University Institute of Social and Preventive Medicine (G.v.M.), Lausanne, Switzerland.

^* To whom correspondence should be addressed. E-mail: Julien.Bogousslavsky{at}chuv.hospvd.ch.

Background and Purpose--Although stroke is one of the main public health problems worldwide, no study of stroke incidence has been performed in Georgia, and therefore, a population-based registry was established to determine the incidence and case-fatality rates of first-ever stroke.

Methods--We identified all first-ever strokes between November 2000 and July 2003 in a defined population of 51 246 residents in the Sanzona suburb of Tbilisi, the capital of Georgia, using overlapping sources of information and standard diagnostic criteria.

Results--A total of 233 first-ever strokes occurred during the study period. The crude annual incidence rate was 165 (95% CI, 145 to 188) per 100 000 residents. The corresponding rate adjusted to the standard "world" population was 103 (95% CI, 89 to 117). In terms of stroke subtype, the crude annual incidence rate per 100 000 inhabitants was 89 (95% CI, 74 to 106) for ischemic stroke, 44 (95% CI, 34 to 57) for intracerebral hemorrhage, 16 (95% CI, 10 to 25) for subarachnoidal hemorrhage, and 16 (95% CI, 10 to 25) for unspecified stroke, and the corresponding case-fatality rates at 1 month were 19.2%, 48.4%, 47.8%, and 69.6%.

Conclusion--The overall stroke incidence rate in an urban population of Georgia is comparable to those reported in developed countries. As for the stroke subtypes, there is an excess of hemorrhagic strokes compared with other registries. Geographical and lifestyle variations may explain these findings, whereas inadequacy of the stroke care system in Georgia might contribute to the high case-fatality.

Key words: epidemiology • incidence • stroke

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