Introduction: Stroke is the second leading cause of death worldwide and the third in most Western countries. Stroke also represents the leading cause of adult disability maintaining a relevant economic burden in terms of health care costs and lost productivity. Methods: The L'Aquila registry was aimed to evaluate stroke incidence, risk factors, comorbidities, mortality, and recurrences in a well-defined and stable population and to compare local data with regional, national, and international data in order to formulate guidelines for patients at risk of stroke and to improve the organization of health services and of medical care. All patients living in the L'Aquila district with a first-ever stroke in a 5-year period were included in the prospective registry. The registry complies with established criteria for stroke incidence studies. Results: From January 1994 up to December 1998, 4,353 patients (2,049 men and 2,304 women: mean age 74.8±11.4 years) with a first-ever stroke were included in the registry. Eighty-eight percent of the patients had neuroimaging studies of the brain. The occurrence of subarachnoid hemorrhage, intracerebral hemorrhage, cerebral infarction, and ill-defined events was 2.7%, 13.5%, 82.6%, and 1.2%, respectively. Crude annual incidence of first-ever stroke was 2.93/1,000 (95% confidence interval [CI], 2.90-2.96) and 2.34/1,000 after standardization to the 1996 European population. The incidence increased with age and was 24.89/1,000 in patients aged over 85 years of age. Annual incidence rates progressively increased from 2.75/1,000 in 1994 up to 3.19 in 1998 with a mean increase of 1.76% per year. The increase was particularly evident for ischemic stroke and more pronounced for women aged over 85 years of age (8.52% per year; P=0.0213). The 30-day case-fatality rate was 25.9% (95% CI, 24.6-27.2). The 1-year case-fatality rate was 37.9% (95% CI, 36.5-39.4). Case-fatality rates were higher for intracerebral hemorrhage than for cerebral infarction at 30 days (48.1% vs 21.2%) and at 1 year (57.7% vs 33.8%). Conclusions: So far, the L'Aquila registry is the largest population-based stroke registry, covering the full spectrum of the disease. We found a high stroke incidence, and an icreasing stroke incidence trend, especially in the older age subgroups, suggesting that rather than declining, stroke is only postponed until later in life.
|Translated title of the contribution||Stroke in Italy: Five-year results of the L'Aquila stroke registry (1994-1998) and comparison with comparable national and international population studies|
|Number of pages||27|
|Journal||Rivista Italiana di Neurobiologia|
|Publication status||Published - 2006|
ASJC Scopus subject areas
- Clinical Neurology