High stroke incidence in the prospective community-based L'Aquila registry (1994-1998): First year's results

Antonio Carolei, Carmine Marini, Mario Di Napoli, Giacinto Di Gianfilippo, Paola Santalucia, Massimo Baldassarre, Giorgio De Matteis, Ferdinando Di Orio

Research output: Contribution to journalArticle

Abstract

Background and Purpose: Changes in stroke incidence are likely to occur as a consequence of aging of the population, but evidence for this hypothesis is lacking. Methods: A prospective community-based registry of first-ever strokes (1994 to 1998) classified according to the International Classification of Diseases, 9th Revision (ICD-9) was established in the L'Aquila district, central Italy, with a total population of 297 838 (1991 census). Patients were identified by active monitoring of multiple sources, including general practitioners. Results: In 1994, 819 patients (398 men and 421 women; mean±SD age, 74.8±11.3 years) suffered from a first-ever stroke. Eighty-nine percent of the patients had neuroimaging studies of the brain and were reclassified with the recent Application of the International Classification of Diseases to Neurology (ICD-10 NA). The occurrence of subarachnoid hemorrhage, intracerebral hemorrhage, cerebral infarction, and ill-defined events was 2.9%, 14.9%, 80.2%, and 2.0%, respectively. Crude annual incidence of first-ever stroke was 2.75/1000 (95% confidence interval [CI], 2.57 to 2.94) and 24.23/1000 (95% CI, 21.65 to 27.10) in patients older than 80 years. Incidence rates were higher in men and steeply increased with age. The standardized rate was 2.37/1000 for the Italian and 2.28/1000 for the European population. The 30-day case-fatality rate was 25.6% (95% CI, 22.8% to 28.7%). The occurrence of death, disability, and full recovery at 1 year was 36.9%, 38.9%, and 24.2%, respectively. No differences were found in stroke incidence and case-fatality according to income and urban or rural residences. Conclusions: In our population-based study, we found a high stroke incidence notably in the older age subgroups, suggesting that rather than declining, stroke is only being postponed until later in life.

Original languageEnglish
Pages (from-to)2500-2506
Number of pages7
JournalStroke
Volume28
Issue number12
Publication statusPublished - Dec 1997

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Keywords

  • Aging
  • Cerebral infarction
  • Incidence
  • Intracerebral hemorrhage
  • Registries
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Carolei, A., Marini, C., Di Napoli, M., Di Gianfilippo, G., Santalucia, P., Baldassarre, M., De Matteis, G., & Di Orio, F. (1997). High stroke incidence in the prospective community-based L'Aquila registry (1994-1998): First year's results. Stroke, 28(12), 2500-2506.