title: Stroke incidence and case fatality in Shiga, Japan 1989-1993.
abstract: BACKGROUND
  This paper describes incidence rates and case-fatality for sub-types of stroke using data collected in Takashima, Shiga, Japan, from 1989 to 1993 and compares these with similar registers in other parts of Japan.
  
  
  METHODS
  Registered patients included all residents of the county who experienced a first-ever stroke. Stroke was defined as sudden onset of neurological symptoms which continued for a minimum of 24 hours or led to death. Almost all such patients are hospitalized in this country. Early case fatality was defined as patients who died within 28 days of stroke onset. Diagnosis of stroke type was based on clinical symptoms as well as computed tomography (CT) scans.
  
  
  RESULTS
  Age-adjusted incidence rates for stroke per 100,000 population aged 35 years and older were 268.7 for men and 167.5 for women. The age-specific incidence rate of both cerebral infarction and cerebral haemorrhage increased with advancing age. The occurrence of cerebral infarction in men was twice as high as in women. The 28-day case fatality for all sub-types of stroke was 16.1% in men and 15.8% in women. Case fatality for cerebral infarction, cerebral haemorrhage, and subarachnoid haemorrhage was 10.7%, 22.4% and 28.6% respectively.
  
  
  CONCLUSIONS
  Takashima County has a moderately high stroke incidence rate and case fatality compared with other similar studies in Japan. The incidence rate of cerebral infarction in men is twice that in women, while other sub-types of stroke showed smaller differences. In order to decrease the incidence of stroke in Japan, greater efforts at primary prevention will be necessary, in particular, it is important to prevent cerebral infarction in men.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Seta, Otsu, Japan. kita@sums.shig-med.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Kita
authors.forename: A
authors.initials: A
authors.lastname: Okayama
authors.forename: H
authors.initials: H
authors.lastname: Ueshima
authors.forename: M
authors.initials: M
authors.lastname: Wada
authors.forename: A
authors.initials: A
authors.lastname: Nozaki
authors.forename: S R
authors.initials: SR
authors.lastname: Choudhury
authors.forename: R
authors.initials: R
authors.lastname: Bonita
authors.forename: Y
authors.initials: Y
authors.lastname: Inamoto
authors.forename: T
authors.initials: T
authors.lastname: Kasamatsu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed