title: A prospective community-based study of stroke in Germany--the Erlangen Stroke Project (ESPro): incidence and case fatality at 1, 3, and 12 months.
abstract: OBJECTIVE
  In Germany, basic data on stroke morbidity are lacking. If a population-based register in former East Germany is excluded, only routine mortality statistics have thus far provided information on epidemiology of stroke. Therefore, a population-based register of stroke was set up in Southern Germany to determine incidence and case fatality in a defined German population.
  
  
  METHODS
  The Erlangen Stroke Project (ESPro) is a prospective community-based study among the 101 450 residents of the city of Erlangen, Bavaria, Germany. Standard definitions and overlapping case-finding methods were used to identify all cases of first-ever stroke in all age-groups, occurring in the 2 years of registration (April 1, 1994, to March 31, 1996). All identified cases of first-ever strokes were followed up at 3 and 12 months from onset.
  
  
  RESULTS
  During 2 years of registration, 354 first-ever-in-a-lifetime strokes (FELS) were registered. The diagnosis and stroke type were confirmed by CT scan in 95% of cases. Fifty-one percent of all FELS occurred in the age group >/=75 years of age. The crude annual incidence rate was 1.74 per 1000 (1.47 for men and 2.01 for women). After age-adjustment to the European population, the incidence rate was 1.34 per 1000 (1.48 for men and 1. 25 for women). The annual crude incidence rate of cerebral infarction was 1.37/1000, intracerebral hemorrhage 0.24/1000, subarachnoid hemorrhage 0.06/1000, and unspecified stroke 0.08/1000. Overall case fatality at 28 days was 19.4%, at 3 months it was 28.5%, and at 1 year 37.3%.
  
  
  CONCLUSIONS
  The first prospective community-based stroke register including all age groups in Germany revealed incidence rates of stroke similar to those reported from other population-based studies in western industrialized countries, but lower than that observed in former East Germany.
authors.affiliation: Department of Neurology, Friedrich-Alexander Universitaet Erlangen-Nuremberg, Erlangen, Bavaria, Germany. kolominsky@psych.med.uni-erlangen.de
authors.forename: P L
authors.initials: PL
authors.lastname: Kolominsky-Rabas
authors.forename: C
authors.initials: C
authors.lastname: Sarti
authors.forename: P U
authors.initials: PU
authors.lastname: Heuschmann
authors.forename: C
authors.initials: C
authors.lastname: Graf
authors.forename: S
authors.initials: S
authors.lastname: Siemonsen
authors.forename: B
authors.initials: B
authors.lastname: Neundoerfer
authors.forename: A
authors.initials: A
authors.lastname: Katalinic
authors.forename: E
authors.initials: E
authors.lastname: Lang
authors.forename: K G
authors.initials: KG
authors.lastname: Gassmann
authors.forename: T R
authors.initials: TR
authors.lastname: von Stockert
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000145:classification / Q000453:epidemiology* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D017678:Sex Distribution; D013997:Time Factors