Incidence, etiology and long-term prognosis of stroke

Background and Purpose: In Germany, basic data on stroke morbidity are lacking. So far only routine mortality statistics have provided information on epidemiology of stroke. Therefore, a population-based register of stroke was set up in Germany to determine incidence and case fatality in a defined German population. Methods: The Erlangen Stroke Register is a prospective community-based study among the 101450 residents of the city of Erlangen, Bavaria, Germany. All identified cases of first-ever strokes were followed-up to 12 months from onset of stroke. Results: During 2 years of registration, 354 first-ever-in-a-lifetime strokes (FELS) were registered. The diagnosis and stroke type were confirmed by CT scan in 95% of cases. Fifty-one percent of all FELS occurred in the age group >75 years of age. After age-adjustment to the German standard population, the incidence rate was 182 per 100000 (200 per 100000 for men and 170 per 100000 for women). Overall case fatality at 28 days was 19.4%, at 3 months it was 28.5%, and at 1 year 37.3%. Conclusions: The first prospective community-based stroke register in Germany including all age groups revealed incidence rates of stroke similar to those reported from other population-based studies in western industrialized countries.