Temporal trends of stroke in Valle d'Aosta, Italy. Incidence and 30-day fatality rates

Dalessandro, Giuseppe; Bottacchi, E.; Giovanni, Marco Di; Martinazzo, C.; Sironi, Luca; Lia, C.; Carenini, L.; Corso, Giovanni; Gerbaz, V.; Polillo, C.; Compagnoni, M. Pesenti

doi:10.1007/s100720070113

Cited by 40 publications

(21 citation statements)

References 8 publications

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“…Eighteen studies reported incidences for men and women separately 5 9 10 17 18 20 22 27 29 35 44 45 47 49 50 52 54 57. The overall incidence in this subset of studies was 10.5 (95% CI 9.9 to 11.2) per 100 000 person-years; the incidence for men was 9.2 (95% CI 8.4 to 10.2) and for women 11.5 (95% CI 10.6 to 12.6).…”

Section: Resultsmentioning

confidence: 99%

Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends

Rooij

Linn

Plas

et al. 2007

Journal of Neurology, Neurosurgery & Psychiatry

1,017

625

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Background and aim: To update our 1996 review on the incidence of subarachnoid haemorrhage (SAH) and assess the relation of incidence with region, age, gender and time period. Methods: We searched for studies on the incidence of SAH published until October 2005. The overall incidences with corresponding 95% confidence intervals were calculated. We determined the relationship between the incidence of SAH and determinants by means of univariate Poisson regression. Results: We included 51 studies (33 new), describing 58 study populations in 21 countries, observing 45 821 896 person-years. Incidences per 100 000 person-years were 22.7 (95% CI 21.9 to 23.5) in Japan, 19.7 (18.1 to 21.3) in Finland, 4.2 (3.1 to 5.7) in South and Central America, and 9.1 (8.8 to 9.5) in the other regions. With age category 45-55 years as the reference, incidence ratios increased from 0.10 (0.08 to 0.14) for age groups younger than 25 years to 1.61 (1.24 to 2.07) for age groups older than 85 years. The incidence in women was 1.24 (1.09 to 1.42) times higher than in men; this gender difference started at age 55 years and increased thereafter. Between 1950 and 2005, the incidence decreased by 0.6% (1.3% decrease to 0.1% increase) per year. Conclusions: The overall incidence of SAH is approximately 9 per 100 000 person-years. Rates are higher in Japan and Finland and increase with age. The preponderance of women starts only in the sixth decade. The decline in incidence of SAH over the past 45 years is relatively moderate compared with that for stroke in general.

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Section: Resultsmentioning

confidence: 99%

Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends

Rooij

Linn

Plas

et al. 2007

Journal of Neurology, Neurosurgery & Psychiatry

1,017

625

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“…In particular in the 1989–1997 interval an increase in stroke incidence was reported [29]: ageing of the population and better cases identification could explain the higher incidence rate. In a previous study (2004–2005) we reported a major reduction in the incidence of stroke (29 %) between 1989 and 2004–2005 [12].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of stroke in Northern Italy: the Cerebrovascular Aosta Registry, 2004–2008

Corso¹,

Bottacchi²,

Giardini³

et al. 2012

Neurol Sci

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Our aim was to prospectively ascertain the incidence of first-ever stroke and ischaemic stroke subtypes, mortality, functional outcome and recurrence in Northern Italy. We identified all possible cases of stroke (1st January 2004 and 31st December 2008). Multiple overlapping sources were used. Standard definitions for incident cases, pathological types and infarction subtypes were used. Patient characteristics were identified and analysed, case-fatality was ascertained from administrative databases, and outcome was assessed in all surviving patients by modified Rankin Scale. We identified 1,326 incident strokes. The pathological diagnosis was confirmed in 94 % of cases. The incidence of first-ever stroke was 80.2 per 100,000 (95 % CI 73–87) when adjusted to world population. The incidence of embolic stroke was significantly greater in women than in men (p < 0.001) whereas the incidence of atherothrombotic stroke was significantly greater in men than in women (p < 0.001). The case-fatality of incident strokes was 9.5 % at 7 day, 16.1 % at 28 day, and 29.9 % at 1 year. Case-fatality of ischaemic stroke was lower than that of other pathological types (p < 0.0001). Hypertension was the most important risk factor, and atrial fibrillation was the most common in embolic stroke. Increasing age, female gender and embolic stroke subtypes were associated with an adverse outcome. Data on stroke incidence and case-fatality were similar to those of other high-income countries. However, differences were found in the distribution of risk factors and prognosis across the stroke types and ischaemic stroke subtypes. Gender differences in long-term functional outcomes were significant.

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“…These registers started for different purposes; they were basically prospective studies aiming at estimating the impact of stroke, understanding variation in the quality of care and outcome after stroke, and answering issues related to case mix and stroke health care, quality factors on the variations in health of stroke patients. Attack rates from the Italian register appeared, for the common age range, to be lower than those registered in the Aosta Valley region (men: 38/10,000 in the age range 55–64 and 98/10,000 in the upper one; women: 18/10,000 and 63/10,000 in the two age ranges, respectively) [6] and in the city of l’Aquila (men: 29/10,000 in the age range 55–64 and 97/10,000 in the upper decade; women: 17/10,000 and 70/10,000, respectively) [7]. …”

Section: Discussionmentioning

confidence: 99%

“…In the late 1990s, experiences were documented in Italy in the Aosta Valley region [6] and in the city of l’Aquila [7, 8], where registers including in- and out-of hospital events were implemented. Hospitalized events in these areas were collected; then severity and outcome were assessed through a detailed morbidity and mortality follow-up.…”

Section: Introductionmentioning

confidence: 99%

The Italian Register of Cardiovascular Diseases: Attack Rates and Case Fatality for Cerebrovascular Events

et al. 2007

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Background: The Italian register of cardiovascular diseases is a surveillance system of fatal and nonfatal cardiovascular events in the general population aged 35–74 years. It was launched in Italy at the end of the 1990s with the aim of estimating periodically the occurrence and case fatality rate of coronary and cerebrovascular events in the different geographical areas of the country. This paper presents data for cerebrovascular events. Methods: Currentevents were assessed through record linkage between two sources of information: death certificates and hospital discharge diagnosis records. Events were identified through the ICD codes and duration. To calculate the number of estimated events, current events were multiplied by the positive predictive value of each specific mortality or discharge code derived from the validation of a sample of suspected events. Attack rates were calculated by dividing estimatedevents by resident population, and case fatality rate at 28 days was determined from the ratio of estimated fatal to total events. Results: Attack rates were found to be higher in men than in women: mean age-standardized attack rate was 21.9/10,000 in men and 12.5/10,000 in women; age-standardized 28-day case fatality rate was higher in women (17.1%) than in men (14.5%). Significant geographical differences were found in attack rates of both men and women. Case fatality was significantly heterogeneous in both men and women. Conclusions: Differences still exist in the geographical distribution of attack and case fatality rates of cerebrovascular events, regardless of the north-south gradient. These data show the feasibility of implementing a population-based register using a validated routine database, necessary for monitoring cardiovascular diseases.

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Temporal trends of stroke in Valle d'Aosta, Italy. Incidence and 30-day fatality rates

Cited by 40 publications

References 8 publications

Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends

Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends

Epidemiology of stroke in Northern Italy: the Cerebrovascular Aosta Registry, 2004–2008

The Italian Register of Cardiovascular Diseases: Attack Rates and Case Fatality for Cerebrovascular Events

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