title: Stroke monitoring on a national level: PERFECT Stroke, a comprehensive, registry-linkage stroke database in Finland.
abstract: OBJECTIVE
  Stroke databases are established to systematically evaluate both the treatment and outcome of stroke patients and the structure and processes of stroke services. Comprehensive data collection on this common disease is resource-intensive, and national stroke databases often include only patients from selected hospitals. Here we describe an alternative national stroke database.
  
  
  METHODS
  We established a nationwide stroke database with multiple administrative registry linkages at the individual-patient level. Information on comorbidities; treatments before, during, and after stroke; living status; recurrences; case fatality; and costs were collected for each hospital-treated stroke patient.
  
  
  RESULTS
  The current database includes 94 316 patients with incident stroke between January 1999 and December 2007, with follow-up until December 2008. Annually, 10 500 new patients are being added. One-year recurrence was 13% and case fatality was 27% during the study period. In 2007, 86% of patients survived 1 month and 77% were living at home at 3 months, but the proportion treated in stroke centers (62%) or with nationally recommended secondary preventive medication after ischemic stroke (49%) was still suboptimal.
  
  
  CONCLUSIONS
  In comparison with other national stroke databases, our method enables higher coverage and more thorough follow-up of patients. Information on long-term recurrences, case fatality, or costs is not often included in national stroke databases. Our database has low maintenance costs, but it lacks detailed data on in-hospital processes. Use of national administrative data, where such linkage is possible, saves resources, achieves high rates of long-term follow-up, and allows for comprehensive monitoring of the burden of the disease.
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, PO Box 340, FI-00029 HUS, Finland. atte.meretoja@fimnet.fi.
authors.forename: Atte
authors.initials: A
authors.lastname: Meretoja
authors.forename: Risto O
authors.initials: RO
authors.lastname: Roine
authors.forename: Markku
authors.initials: M
authors.lastname: Kaste
authors.forename: Miika
authors.initials: M
authors.lastname: Linna
authors.forename: Merja
authors.initials: M
authors.lastname: Juntunen
authors.forename: Terttu
authors.initials: T
authors.lastname: Erilä
authors.forename: Matti
authors.initials: M
authors.lastname: Hillbom
authors.forename: Reijo
authors.initials: R
authors.lastname: Marttila
authors.forename: Aimo
authors.initials: A
authors.lastname: Rissanen
authors.forename: Juhani
authors.initials: J
authors.lastname: Sivenius
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012008:Recurrence; D012042:Registries; D020521:Stroke / Q000453:epidemiology*