[Incidence and prognosis of stroke episodes in the East German population. Results from a stroke register 1985-1988]

Abstract

Objectives: To determine the incidence rate of stroke, case-fatality within 28 days and diagnostic accuracy in stroke cases in the study population.

Methods: Prospective stroke register, including all cases of complete stroke which occurred during 1985-1988 in the population aged 25-64 and 25-74, of 14 districts in East Germany. Case-respectively finding, validation and uniform data collection were carried out by physicians trained to use the WHO-MONICA protocol.

Results: Annual age-standardized event rates were 113 per 100,000 for men and 68/100,000 for women aged 25-64, rates for first-ever stroke were 88/100,000 for men and 52/100,000 for women. For both sexes, incidence and event rates rose exponentially with increasing age. Before age 45 more women than men were affected. 34% of patients aged 25-64 had died by 28 days. Case-fatality in men and women aged 65-74 was higher than in those ten years younger (p < 0.01) and tended to be higher in women. 10% of patients aged 25-64 and 26% of those in the age of 65-74 were treated outside hospital. Before age 65, CT examination and angiography were done in only 18 and 20%, respectively; in elderly patients even less frequently.

Conclusions: The findings suggest that since the 1970s there may have been an increase of stroke incidence in the population of Eastern Germany. The high case-fatality following stroke is confirmed. Evidently there are deficiencies in the medical care of elderly stroke patients.