title: Trends in case-fatality of stroke in Finland during 1983 to 1992.
abstract: OBJECTIVE
  Stroke mortality has been declining in Finland during the past 20 years. It is not known, however, whether this favorable development is attributable to the decline in the incidence or case-fatality of stroke. For this reason we examined the trends in case-fatality of stroke, including trends by subtype of stroke.
  
  
  METHODS
  The analyses were carried out using data of the community-based FINMONICA Stroke Register, which was operating in three geographic areas of Finland during 1983 to 1992. All stroke events (n = 11,171) in persons aged 35 to 74 years were included in this register.
  
  
  RESULTS
  The 28-day case-fatality of stroke fell yearly by 3.6% (P = .01) in men and by 2.6% (P = .2) in women. At the end of the study period, the average 28-day case-fatality of all strokes was 20% in men and 21% in women. Considerable differences by subtype of stroke were observed. The 28-day case-fatalities at the end of the study period were in men-56% for subarachnoid hemorrhage, 42% for intracerebral hemorrhage, and 14% for cerebral infarction. In women, the corresponding figures were 49%, 49%, and 14%. The 28-day case-fatality of subarachnoid hemorrhage did not change during the study period, but for intracerebral hemorrhage, a significant decline was observed in men and there was a declining trend also in women. The 28-day case-fatality of cerebral infarction declined significantly in both genders.
  
  
  CONCLUSIONS
  With the exception of subarachnoid hemorrhage, the 28-day case-fatality of stroke has fallen in Finland. It is likely that this fall has contributed to the decline in stroke mortality.
authors.affiliation: Health Office City of Turku, Heart and Stroke Center, Finland. pirjo.immonen-raiha@turku.fi
authors.forename: P
authors.initials: P
authors.lastname: Immonen-Räihä
authors.forename: M
authors.initials: M
authors.lastname: Mähönen
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: V
authors.initials: V
authors.lastname: Salomaa
authors.forename: E
authors.initials: E
authors.lastname: Kaarsalo
authors.forename: E V
authors.initials: EV
authors.lastname: Narva
authors.forename: K
authors.initials: K
authors.lastname: Salmi
authors.forename: C
authors.initials: C
authors.lastname: Sarti
authors.forename: J
authors.initials: J
authors.lastname: Sivenius
authors.forename: K
authors.initials: K
authors.lastname: Alhainen
authors.forename: J
authors.initials: J
authors.lastname: Torppa
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000150:complications; D002544:Cerebral Infarction / Q000150:complications; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality*; D005260:Female; D005387:Finland; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D017678:Sex Distribution; D013345:Subarachnoid Hemorrhage / Q000150:complications