High stroke incidence in the prospective community-based L'Aquila registry (1994-1998). First year's results.
OBJECTIVE
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.
Carolei
A
A
Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila-Collemaggio, Italy.
Marini
C
C
Di Napoli
M
M
Di Gianfilippo
G
G
Santalucia
P
P
Baldassarre
M
M
De Matteis
G
G
di Orio
F
F
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries