Effects of urban community intervention on 3-year survival and recurrence after first-ever stroke.
OBJECTIVE
For the past 2 decades, stroke has been a principal cause of death in China, and stroke incidence tends to increase with the increase of stroke-related risk factors. The purpose of this study was to evaluate the effects of urban community-based intervention on 3-year survival and recurrence after first-ever stroke.


METHODS
Two communities with a registered population of approximately 50 000 each were selected as either intervention or control communities in Beijing during 1991 to 2000. Comprehensive intervention measures including the management of high-risk population and the health education of whole community population were regularly implemented. Then the influence of community intervention on 3-year survival and recurrence after initial stroke was evaluated.


RESULTS
Within 3 years, 41.85% of 736 patients in the intervention community died whereas 40.34% of 818 patients in the control community died. Of 223 cases from the intervention community, 26 (11.66%) had a recurrent stroke within 3 years versus 52 (20.80%) of 250 cases from the control community. The statistical difference was found. Compared with the control community, the death risk of first-ever stroke in the intervention community decreased by 26% (relative risk [RR]=0.74; 95% confidence interval [CI]: 0.61 to 0.89; P=0.002); especially, that of hemorrhagic stroke decreased by 39% (RR=0.61; 95%CI: 0.46 to 0.81; P=0.001). Compared with the control community, the recurrence risk of first-ever stroke from the intervention community decreased by 42% (RR=0.58; 95% CI: 0.34 to 1.00; P=0.048).


CONCLUSIONS
Community intervention may be effective and beneficial to the recurrence prevention and survival improvement of stroke, especially hemorrhagic stroke.
Jiang
Bin
B
Department of Neuroepidemiology, Beijing Neurosurgical Institute, 6 Tiantan Xili, Yongnei Street, Chongwen District, Beijing 100050, People's Republic of China. bjyjiang@hotmail.com
Wang
Wen-zhi
WZ
Wu
Sheng-ping
SP
Du
Xiao-li
XL
Bao
Qiu-ju
QJ
D000368:Aged; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D015996:Survival Rate; D014504:Urban Health