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(Stroke. 2008;39:10.)
© 2008 American Heart Association, Inc.

Original Contributions

Stroke Incidence and Survival in the Beginning of the 21st Century in Southern Sweden

Comparisons With the Late 20th Century and Projections Into the Future

Björn Hallström, MD; Ann-Cathrin Jönsson, RN; Christina Nerbrand, MD; Bo Norrving, MD Arne Lindgren, MD

From the Department of Clinical Sciences (B.H., A.C.J., B.N., A.L.), Lund, Neurology, Lund University, and the Department of Clinical Sciences (C.N.), Malmö, Lund University, Sweden.

Correspondence Arne Lindgren, MD, Department of Clinical Sciences, Lund, Neurology, Lund University Hospital, S-221 85 Lund, Sweden. E-mail arne.lindgren{at}med.lu.se

Background and Purpose— We report trends of stroke incidence and survival up to year 2001/2002 in Lund-Orup, Sweden, and projections of future stroke incidence in Sweden.

Methods— Lund Stroke Register, a prospective population-based study, included all first-ever stroke patients, between March 1, 2001 and February 28, 2002, in the Lund-Orup health care district. Institution-based studies for 1983 to 1985 and 1993 to 1995 were used for comparison. We calculated age-standardized incidence and Cox proportional hazards analysis of survival (stroke subtype, sex, age group, and study period in the analysis). Minimum follow-up was 46 months. Based on our register’s stroke incidence and the official Swedish population projection, a projection for future stroke incidence on a national basis was calculated.

Results— We included 456 patients with first-ever stroke in 2001/2002. The age-standardized incidence (to the European population) was 144 per 100 000 person-years (95%CI 130 to 158) in 2001/2002, 158 (95%CI 149 to 168) in 1993 to 1995, and 134 (95%CI 126 to 143) in 1983 to 1985. Cox proportional hazard analysis indicated decreased risk of death after stroke in 2001/2002 (hazard ratio 0.80; 95%CI 0.67 to 0.94) compared with 1993 to 1995. Up to year 2050, the annual number of new stroke patients in Sweden may increase by 59% based solely on demographic changes.

Conclusions— Despite possible underestimation of stroke incidence during the previous institution-based studies, the increased stroke incidence between 1983 to 1985 and 1993 to 1995 did not continue in 2001/2002. The long-term survival after stroke continues to improve. As the elderly population is growing in Sweden, stable incidence and increasing survival will result in a rapidly increasing prevalence of stroke patients in Sweden.

Key Words: case-fatality • epidemiology • incidence • population-based • projection • stroke • survival

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