Temporal Trends of Stroke Epidemiology in Southern Sweden: A Population-Based Study on Stroke Incidence and Early Case-Fatality

Background Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. Aims The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. Methods All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015–2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. Results In total, 1315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100,000 person-years (95% CI 231–239) in 1993/1995, 252 (95% CI 223–286) in 2004, and 211 (192–232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95% CI: 0.72–0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio = 0.72, 95% CI: 0.58–0.90). Conclusions This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.

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Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review

The Lancet Neurology ◽

10.1016/s1474-4422(09)70025-0 ◽

2009 ◽

Vol 8 (4) ◽

pp. 355-369 ◽

Cited By ~ 1358

Author(s):

Valery L Feigin ◽

Carlene MM Lawes ◽

Derrick A Bennett ◽

Suzanne L Barker-Collo ◽

Varsha Parag

Keyword(s):

Systematic Review ◽

Case Fatality ◽

Population Based ◽

Stroke Incidence ◽

Early Case

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Stroke incidence and case fatality: a 9-year prospective population-based study in an elderly population of Bagheria, Italy

Neurological Sciences ◽

10.1007/s10072-020-04830-7 ◽

2020 ◽

Author(s):

Valentina Arnao ◽

Giuseppe Salemi ◽

Salvatore Scondotto ◽

Nicola Casuccio ◽

Marianna Riolo ◽

...

Keyword(s):

Elderly Population ◽

Case Fatality ◽

The Elderly ◽

Population Based ◽

Incidence Rates ◽

World Population ◽

Italian Population ◽

Population Based Study ◽

Stroke Incidence ◽

Epidemiological Surveys

Abstract Background The incidence of stroke in high-income countries has been on the decline; however, few epidemiological surveys have been conducted in recent years to specifically estimate the incidence along with outcome of stroke, in Italy. This study aimed to examine the incidence and case fatality rates of stroke in an elderly Italian population. Methods A cohort of 2200 people > 65 years was randomly stratified from the total elderly population of Bagheria, Italy. A 9-year prospective population-based study was performed (19,800 person/years). Results We identified 112 first-ever strokes, 53 females and 59 males: 82 (73.1%) ischemic, 13(11.6%) intracerebral haemorrhages, 6 (5.35%) subarachnoid haemorrhages, while 11(9.8%) were classified as undetermined strokes. The crude overall annual incidence was 5.65 per 1000 (95%CI: 4.61 to 6.70) for first-ever stroke. The overall crude incidence rates were 4.74 per 1000 (5.08 for males and 4.46 for females) for ischemic stroke, 0.65 (0.99 for males and 0.37 for females) for intracerebral haemorrhage, and 0.03 for subarachnoid haemorrhage. The incidence rate for first-ever stroke was 5.4 per 1000 (95% CI: 5.36 to 5.45) after adjustment for the 2015 World population and 5.56 (95% CI: 5.52 to 5.61), compared to the 2015 European population. Overall case fatality rates for first-ever stroke was 8.19% at 28 days and 24.1% at 1 year. Conclusion Our study shows that in the elderly population investigated, stroke incidence and case fatality rates resulted being lower, compared to those from Italian and most European populations. Similar to previous studies, these rates increased linearly with age and were higher in males.

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Temporal trends in early case-fatality rates in patients with intracerebral hemorrhage

Neurology ◽

10.1212/wnl.0000000000003681 ◽

2017 ◽

Vol 88 (10) ◽

pp. 985-990 ◽

Cited By ~ 21

Author(s):

Yannick Béjot ◽

Michael Grelat ◽

Benoit Delpont ◽

Jérôme Durier ◽

Olivier Rouaud ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Regression Models ◽

Temporal Change ◽

Cox Regression ◽

Temporal Trends ◽

Case Fatality ◽

Population Based ◽

Day Case ◽

Early Case ◽

Population Based Registry

Objective:To assess whether temporal trends in very early (within 48 hours) case-fatality rates may differ from those occurring between 48 hours and 30 days in patients with spontaneous intracerebral hemorrhage (ICH).Methods:All cases of ICH that occurred in Dijon, France (151,000 inhabitants), were prospectively collected between 1985 and 2011, using a population-based registry. Time trends in 30-day case fatality were analyzed in 3 periods: 1985–1993, 1994–2002, and 2003–2011. Cox regression models were used to evaluate associations between time periods and case fatality within 48 hours and between 48 hours and 30 days, after adjustments for demographics, risk factors, severity, and ICH location.Results:A total of 531 ICH cases were recorded (mean age 72.9 ± 15.8, 52.7% women). Thirty-day case fatality gradually decreased with time from 40.9% in 1985–1993 to 33.5% 1994–2002 and to 29.6% in 2003–2011 (adjusted hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.47–1.07, p = 0.106, for 1994–2002, and adjusted HR 0.49, 95% CI 0.32–0.73, p < 0.001, for 2003–2011). Over the whole study period, 43.6% of 1-month deaths occurred within the first 48 hours following ICH onset. There was no temporal change in case fatality occurring within the first 48 hours but a decrease in deaths occurring between 48 hours and 30 days was observed with time (HR 0.53, 95% CI 0.31–0.90, p = 0.02, for 1994–2002, and HR 0.32, 95% CI 0.32–0.55, p < 0.01, for 2003–2011, compared with 1985–1993).Conclusion:Although 30-day case fatality significantly decreased over the last 27 years, additional improvements in acute management of ICH are needed since very early case-fatality rates (within 48 hours) did not improve.

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One-year case fatality rate following stroke in the Mashhad Stroke Incidence Study: a population-based study of stroke in Iran

International Journal of Stroke ◽

10.1111/ijs.12611 ◽

2015 ◽

Vol 10 (SA100) ◽

pp. 96-102 ◽

Cited By ~ 4

Author(s):

Ali Shoeibi ◽

Maryam Salehi ◽

Amanda G. Thrift ◽

Moira K. Kapral ◽

Mohammad Taghi Farzadfard ◽

...

Keyword(s):

Incidence Study ◽

Case Fatality Rate ◽

Case Fatality ◽

Population Based ◽

Fatality Rate ◽

Population Based Study ◽

Stroke Incidence ◽

One Year

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Five-Year Case Fatality Following First-Ever Stroke in the Mashhad Stroke Incidence Study: A Population-Based Study of Stroke in the Middle East

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2017.11.018 ◽

2018 ◽

Vol 27 (4) ◽

pp. 1085-1089

Author(s):

Mohammad Taghi Farzadfard ◽

Amanda G. Thrift ◽

Amin Amiri ◽

Moira K. Kapral ◽

Peyman Hashemi ◽

...

Keyword(s):

Middle East ◽

Incidence Study ◽

Case Fatality ◽

Population Based ◽

Population Based Study ◽

Stroke Incidence

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Estimates and Determinants of SARS-Cov-2 Seroprevalence and Infection Fatality Ratio Using Latent Class Analysis: The Population-Based Tirschenreuth Study in the Hardest-Hit German County in Spring 2020

Viruses ◽

10.3390/v13061118 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1118

Author(s):

Ralf Wagner ◽

David Peterhoff ◽

Stephanie Beileke ◽

Felix Günther ◽

Melanie Berr ◽

...

Keyword(s):

Latent Class Analysis ◽

Latent Class ◽

Care Home ◽

Case Fatality ◽

The Elderly ◽

Population Based ◽

Class Analysis ◽

Population Based Study ◽

Targeted Testing ◽

June July

SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60–69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.

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