title: Hospital-based register of stroke in the Molise Region: focus on main subtypes of stroke. Years 2009-2013.
abstract: We determined incidence and intra-hospital mortality rate of stroke in Molise, Italy, to provide information for planning regional healthcare facilities and to ameliorate stroke management in this region. This study is part of the "Rete Molisana dell'Ictus Cerebrale (REMOLIC)" study, a population-based Cerebrovascular Registry in Molise, from 2009 to 2013, with a cold pursuit approach. The crude annual incidence rates for total stroke per 100,000 inhabitants, notified by hospital discharge records, were 198 for 2009, 185 for 2010, 169 for 2011, and 176 for both 2012 and 2013. There was a significant decrease in risk in the years 2011-2013 [RR2011 vs. 2009: 0.85 (0.76-0.98), RR2012 vs. 2009: 0.89 (0.79-0.99), RR2013 vs. 2009: 0.89 (0.79-0.99)] as compared with 2009. For the year 2010, after adjustment to the Italian, European, and world populations, the overall incidence rates were 165, 134, and 67 per 100,000/year, respectively. Similar trends were found when men and women were analyzed separately. In the average, 20.8 % of subjects admitted for a cerebrovascular accident died during the hospitalization, among these 93.5 % in the first 28 days. The duration of hospital stay was constant in the years (2009-2012), except during 2013, where there was a significant decrease in the average (p < 0.001). Our study shows incidence rates decreasing from 2009 to 2013, while mortality rates were stable during the same years. This study underlines the need to plan better stroke management in Italy, in order to obtain outcomes more similar to those of the best performing countries.
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Viale dell'Elettronica, 86077, Pozzilli, Italy. licia.iacoviello@neuromed.it.
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Viale dell'Elettronica, 86077, Pozzilli, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Costanzo
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Viale dell'Elettronica, 86077, Pozzilli, Italy.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Persichillo
authors.affiliation: Centro per la diagnosi e la cura dell'ictus cerebri (Stroke Unit), Pozzilli, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sparano
authors.affiliation: Unità di Neuroriabilitazione, IRCCS Istituto Neurologico Mediterraneo, Neuromed, Pozzilli, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Bartolo
authors.affiliation: Direzione Generale della Prevenzione Sanitaria - CCM, Ministero della Salute, Rome, Italy.
authors.forename: Bianca Maria
authors.initials: BM
authors.lastname: Polizzi
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Viale dell'Elettronica, 86077, Pozzilli, Italy.
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Viale dell'Elettronica, 86077, Pozzilli, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult
keywords: Cerebrovascular registry; Hospital discharge records; Intracerebral hemorrhage; Ischemic stroke; Subarachnoid hemorrhage