Stroke Incidence and Survival in Ludwigshafen am Rhein, Germany

Palm, Frederick; Urbanek, Christian; Rose, Steffen; Buggle, Florian; Bode, Barbara; Hennerici, Michael G.; Schmieder, Kirsten; Inselmann, G.; Reiter, Rainer; Fleischer, Robert; Piplack, Karl-Otto; Safer, Anton; Becher, Heiko; Grau, Armin J.

doi:10.1161/strokeaha.110.592642

Cited by 78 publications

(78 citation statements)

References 23 publications

(27 reference statements)

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“…ICH alone has a nearly 40% case-fatality rate at 30 days. 116,117 Although it may seem straightforward to define hemorrhagic subtypes of stroke, a number of issues should be considered, including traumatic injury or secondary causes of bleeding, and the impact of newer technologies on the diagnosis of hemorrhage, among others. Hemorrhages in the CNS should be classified as stroke if they are nontraumatic, caused by a vascular event, and result in injury to the CNS.…”

Section: Cerebral Hemorrhagementioning

confidence: 99%

An Updated Definition of Stroke for the 21st Century

Sacco¹,

Kasner²,

Broderick³

et al. 2013

Stroke

2,454

1,006

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Despite the global impact and advances in understanding the pathophysiology of cerebrovascular diseases, the term “stroke” is not consistently defined in clinical practice, in clinical research, or in assessments of the public health. The classic definition is mainly clinical and does not account for advances in science and technology. The Stroke Council of the American Heart Association/American Stroke Association convened a writing group to develop an expert consensus document for an updated definition of stroke for the 21st century. Central nervous system infarction is defined as brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging, and/or clinical evidence of permanent injury. Central nervous system infarction occurs over a clinical spectrum: Ischemic stroke specifically refers to central nervous system infarction accompanied by overt symptoms, while silent infarction by definition causes no known symptoms. Stroke also broadly includes intracerebral hemorrhage and subarachnoid hemorrhage. The updated definition of stroke incorporates clinical and tissue criteria and can be incorporated into practice, research, and assessments of the public health.

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Section: Cerebral Hemorrhagementioning

confidence: 99%

An Updated Definition of Stroke for the 21st Century

Sacco¹,

Kasner²,

Broderick³

et al. 2013

Stroke

2,454

1,006

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“…Elderly aged 80 years old or older are almost 20 times more likely to have a stroke than those who are 40 to 49 years old. Heuschmann et al 14 identified that the incidence of stroke worldwide also increases progressively each decade of life, as well as Liu et al 15 and Palm et al 28 . In this situation, differently from the issue raised for gender, it seems important to develop actions with a different focus for the age ranges from the fourth decade of life on as for the treatment, as well as the lifestyle.…”

Section: Discussionmentioning

confidence: 96%

Hospitalização por acidente vascular encefálico isquêmico no Brasil: estudo ecológico sobre possível impacto do Hiperdia

Lopes

Sanchis

Medeiros

et al. 2016

Rev. bras. epidemiol.

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Objective:The study evaluated the trend of hospitalization for ischemic stroke (HIS) and its hospital mortality in Brazil over the last 15 years as well as the impact of the Hiperdia program in this scenario. Methods: An ecological study was designed with analytical approach and data collected in the Hospital Admission System on episodes of stroke, over the years 1998 to 2012. All data were stratified by sex and age, creating an indicator for HIS and proportion of hospital mortality. To estimate the trend of the data a polynomial curve fitting was created; and the Generalized Linear Model was applied to investigate the impact of Hiperdia on the endpoint HIS and hospital mortality. We adopted a 5% significance level to minimize an error type I. Results: We observed a reduction of HIS from 37.57/10 5 inhabitants in 1998 to 2001 to 10.33/10 5 inhabitants in 2002 to 2005, declining 73.64%. The reduction occurred in both sexes and for all age groups. The mortality rate of ischemic stroke also declined in Brazil since 2002, in both men and women, therefore in less than 3%; and only in the groups aged between 0 and 14 and above 80 years, we did not detect trend. Conclusion: Therefore, the decline of HIS temporally coincided with the implementation of Hiperdia in 2002 and this trend continues today.

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“…Within Germany, estimates from these registries indicate corresponding rates for 55-to 64-year-old persons varying from 188 to 368 for men and from 203 to 240 for women. 15,16 Studies in Europe and Asia indicate ≤8-fold variation in 1-year incidence rates ranging from ≈100/100 000 in Italy 17 to 330 to 433/100 000 in The Netherlands and Japan 18,19 and with relatively extreme values as high as from 500 to 800/100 000 in Ukraine and Russia 20,21 for men and women aged 55 to 64 years. The incidence rates in Germany and in our cohort thus lay within the midrange of the rates reported worldwide.…”

Section: Discussionmentioning

confidence: 99%

Primary Preventive Potential for Stroke by Avoidance of Major Lifestyle Risk Factors

Tikk

Sookthai

Monni

et al. 2014

Stroke

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EPIC-Heidelberg is a prospective cohort study that is a part of a large-scale Europe-wide study, the EPIC. The full EPIC-Heidelberg cohort consists of 25 540 persons comprised of 11 928 men aged 40 to 64 years and 13 612 women aged 35 to 64 years, who were Background and Purpose-Because primary prevention of stroke is a priority, our aim was to assess the primary preventive potential of major lifestyle risk factors for stroke in middle-aged women and men. Methods-Among 23 927 persons, 551 (195 women and 356 men) had a first diagnosis of stroke during an average followup of 12.7 years. Using Cox proportional hazards models, we estimated the associations of adiposity, smoking, physical activity, alcohol consumption, and diet with risk of developing stroke. A competing risk model built from cause-specific proportional hazards models accounting for concurrent risk of death was used to calculate relative and absolute reductions in stroke occurrences that could have been achieved by maintaining a healthy lifestyle pattern. Results-Obesity, smoking, alcohol consumption, diet, and physical inactivity were each identified as modifiable lifestyle risk factors for stroke. About 38% of stroke cases were estimated as preventable through adherence to a healthy lifestyle profile (never smoking, maintaining optimal body mass index and waist circumference, performing physical exercise, consuming a moderate quantity of alcohol, and following a healthy dietary pattern). Age-specific estimates of 5-year incidence rates for stroke in the actual cohort and in a hypothetical, comparable cohort of individuals following a healthy lifestyle would be reduced from 153 to 94 per 100 000 women and from 261 to 161 per 100 000 men for the age group 60 to 65 years. Conclusions-Our analysis confirms the strong primary prevention potential for stroke based on avoidance of excess body weight, smoking, heavy alcohol consumption, unhealthy diet, and physical inactivity.

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Stroke Incidence and Survival in Ludwigshafen am Rhein, Germany

Cited by 78 publications

References 23 publications

An Updated Definition of Stroke for the 21st Century

An Updated Definition of Stroke for the 21st Century

Hospitalização por acidente vascular encefálico isquêmico no Brasil: estudo ecológico sobre possível impacto do Hiperdia

Primary Preventive Potential for Stroke by Avoidance of Major Lifestyle Risk Factors

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