Stroke incidence and 30-day and six-month case fatality rates in Udine, Italy: a population-based prospective study

Authors

  • Francesco Janes,

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Gian Luigi Gigli,

    Corresponding author
    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
    • Correspondence: Gian Luigi Gigli*, Department of Neurology, University of Udine Medical School, ‘S. Maria della Misericordia’ University Hospital, Piazza Santa Maria della Misericordia, 33100 Udine, Italy.

      E-mail: gigli@uniud.it

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  • Lucio D'Anna,

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Iacopo Cancelli,

    1. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Anna Perelli,

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Giessica Canal,

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Valentina Russo,

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Barbara Zanchettin,

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Mariarosaria Valente

    1. Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
    2. Department of Neurosciences, ‘S. Maria della Misericordia’ University Hospital, Udine, Italy
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  • Conflict of interest: None declared.
  • Funding: The study has been made possible, thanks to a grant of the Italian Ministry of Health (PRF 18-06).

Abstract

Background

Stroke incidence in high-income countries is reported to decrease, and new data on stroke incidence and outcome are needed to design stroke services and to ameliorate stroke management.

Methods

This study is part of a two-year prospective community-based registry of all cerebrovascular events in the district of Udine (153 312 inhabitants), Friuli-Venezia Giulia region, northeast of Italy, between 1 April 2007 and 31 March 2009. Overlapping sources for case finding were used, combining hot and cold pursuit.

Results

We identified 784 stroke cases, 640 (81·6%) incident. The crude overall annual incidence rate per 100 000 residents was 256 (95% confidence interval 241–271) for all strokes and 209 (95% confidence interval 195–223) for first-ever strokes. Incidence rate for first-ever strokes was 181 (95% confidence interval 155–211) after adjustment to the 2007 Italian population and 104 (95% confidence interval 88–122) compared with the European standard population. Incidence rates for first-ever strokes was 215 (196–235) for women, 202 (183–223) for men. Crude annual incidence rates per 100 000 population were 167 (153–178) for ischemic stroke, 31 (26–37) for intracerebral hemorrhage, 8·1 (5·7–11·4) for sub-arachnoid hemorrage, and 4·6 (2·8–7·1) for undetermined stroke. Overall case fatality rates for first-ever stroke were 20·6% at 28 days and 30·2% at 180 days.

Conclusions

Our study shows incidence rates higher than previously reported in our region but not supporting the view of higher incidence rates in Northern than in Southern Italy. Results contribute to time-trends analysis on epidemiology, useful for dimensioning services in Italy and show the persistence of a gap between the outcome of stroke in Italy and that of the best performing European countries, urging to adopt better stroke management plans.

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