Standardized Incidence Ratios of Stroke: A Worldwide Review

Alter, Miriam J.; Zhang, Z X; Sobel, Eugene; Fisher, Marc; Davanipour, Zoreh; Friday, Gary

doi:10.1159/000110824

Cited by 41 publications

(26 citation statements)

References 10 publications

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“…11 From these comparisons, we conclude that for any of the above parameters, we could find Ն1 West European countries with parameters similar to those of Ukraine. Our results cast doubt on the accuracy of WHO data of high stroke mortality in Ukraine, as well as on the generalizability of the east-west gap of stroke epidemiological data, and support the assumption of Alter et al 13 that much of the reported variation in stroke mortality and incidence rates between populations may be attributed to methodological issues.…”

Section: Discussionsupporting

confidence: 51%

A Population Study of Stroke in West Ukraine

Mihálka

Smolanka

Bulecza

et al. 2001

Stroke

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Background and Purpose-According to World Health Organization statistics, Ukraine has extremely high stroke mortality. No population-based prospective studies of stroke incidence have been performed yet in this European country with Ϸ50 million inhabitants. High reported rates of stroke mortality in official statistics conflict with some locally published incidence data in Ukraine. To obtain accurate data, we evaluated stroke incidence and 30-day case fatality in a prospective population study in the West Ukrainian city of Uzhgorod with a population of 126 000 inhabitants. Methods-Case certification by neurologists and follow-up at 30 days after stroke for all patients identified by any level of the health service system were performed for a 12-month period. Results-We identified 352 stroke cases. The age-standardized incidence was 341 and 238 of 100 000 and mortality was 83 and 69 of 100 000 with the use of the European or world standard population for standardization. Mean age of stroke patients was 63.4Ϯ12.5 years. Rate of hospitalization was 66%. Hospitalized patients were Ͼ10 years younger than those treated in their homes. The 30-day case fatality rates were 15.4% among hospitalized patients and 36.8% among those treated at home. Overall 30-day case fatality was 23.3%. Conclusions-Stroke incidence and 30-day case fatality in this West Ukrainian city were similar to those of some West European countries and were much lower than what could be expected from World Health Organization statistics. The relatively low incidence rate seems accurate; because of the organization of local stroke services, it is not probable that a considerable proportion of patients with acute stroke could bypass all levels of the acute care health system. Local health statistics reported a much lower number of stroke cases and stroke deaths than found in our survey; thus, further study is needed to clarify the reason for the discrepancy between local data and the high reported stroke mortality in

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Section: Discussionsupporting

confidence: 51%

A Population Study of Stroke in West Ukraine

Mihálka

Smolanka

Bulecza

et al. 2001

Stroke

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“…15 In the absence of basic demographic data in our target population, the age-adjusted rate could not be calculated, and the only conclusion that can be made is that our crude incidence rate was low but similar to that found in other developing countries12'13 where the population is predominantly young. Our male-female ratio of 2.2:1 was high compared with other studies and difficult to explain but similar to that found in the stroke registry in eastern Saudi Arabia.…”

Section: Resultsmentioning

confidence: 57%

Stroke in a Saudi Arabian National Guard community. Analysis of 500 consecutive cases from a population-based hospital.

Rajeh

Awada

Niazi

et al. 1993

Stroke

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“…It was however consistent with the 43.8/100,000 crude incidence found in a community-based hospital in Riyadh [10] and with the low stroke prevalence of 186/100,000 found in the only door-to-door survey carried out in the eastern province of Saudi Arabia [18]. The age-adjusted annual incidence rate of 125.8/100,000 was however within the range of 105–280/100,000 observed in most studies worldwide [19]. Our low crude figure mainly reflected the young age structure of the Saudi population in KSA where 76% are below 35 years of age and only 3% are over 65 years old [12].…”

Section: Discussionmentioning

confidence: 90%

Stroke Register: Experience from the Eastern Province of Saudi Arabia

Larbi²,

et al. 1998

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A stroke registry was established in the Eastern Province of Saudi Arabia with an estimated population of 750,000 inhabitants of whom 545,000 are Saudi citizens. The register started in July 1989 and ended in July 1993. The Gulf war led to its interruption from August 1990 to August 1991. Four hundred eighty-eight cases (314 males, 174 females) of first-ever strokes affecting Saudi nationals were registered over the 3-year period. The crude incidence rate for first-ever strokes was 29.8/100,000/year (95% CI: 25.2–34.3/100,000 year). When standardized to the 1976 US population, it rose up to 125.8/100,000/year. Ischemic strokes (69%) predominated as in other studies but subarachnoid hemorrhage (SAH) was extremely rare (1.4%). The important risk factors were: systemic hypertension (38%), diabetes mellitus (37%), heart disease (27%), smoking (19%) and family history of stroke (14%). Previous transient ischemic attacks (3%) and carotid bruits (1%) were uncommon. The 30-day case fatality rate was 15%. The study showed that the age-adjusted stroke incidence rate for Saudis in this region is lower than the rates reported in developed countries but within the range reported worldwide. The pattern of stroke in Saudi Arabia is not different from that reported in other communities with the exception of the low incidence of SAH. The risk factors are similar to findings in other studies except for the high frequency of diabetes mellitus in our cases. The lower mortality rate was probably due to the younger age of the population and the availability of free medical services for management of cases.

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Standardized Incidence Ratios of Stroke: A Worldwide Review

Cited by 41 publications

References 10 publications

A Population Study of Stroke in West Ukraine

A Population Study of Stroke in West Ukraine

Stroke in a Saudi Arabian National Guard community. Analysis of 500 consecutive cases from a population-based hospital.

Stroke Register: Experience from the Eastern Province of Saudi Arabia

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