Tancioni Valeria, Collini Francesca, Balzi Daniela, Barchielli Alessandro, Gnavi Roberto, Picariello Roberta, Tessari Roberta, Simonato Lorenzo
Laziosanita Agenzia di sanita pubblica.
Epidemiol Prev. 2008 May-Jun;32(3 Suppl):38-45.
to define an algorithm and implement it in various areas of Italy, in order to evaluate acute stroke incidence through current databases.
Lazio, Tuscana , Venezia AULSS 12, Torino ASL 5.
resident-based population in the above mentioned 4 areas during 2002-2004.
Annual and triennal incidence rate (crude and standardized per 100,000 inhabitants with 95% CI) by sex and age classes (0-14, 15-34, 35-54, 55-64, 65-74, 75-84, 85+), standardized rate of mortality by sex and areas.
acute stroke incident cases during 2002-2004 in the 4 Italian areas were identified through hospitalization databases (SDO) and death causes (CM). The selection was made including hospitalization cases (no outpatients) and deceased people with a discharge or death code ICD9-CM 430*, 431*, 434*, 436* with no hospitalization for stroke diagnosis in the previous 60 months. Moreover, patients with 438* codes in secondary diagnoses and patients with hospital discharge from rehabilitation or long-hospital units were excluded.
men have a higher crude incidence rate than women (+30%). The age-specific rates show a large variability among the areas for elderly people (65+ for men and 75+ for women), with higher rates in Toscana in both genders (cases per 100,000 inhabitants: 260.1 men; 193.1 women). Intermediate values were found in Torino and in Lazio; the lowest values are reported in Venezia (men: 182.5; women: 1368). Standardized mortality rates also present higher mortality levels in the two regional areas (Lazio and Toscana) and lower levels in the two urban areas (Torino and Venezia).
It is not easy to evaluate the algorithm. Results seem compatible enough with other studies and show a certain consistency with current mortality data. Different socio-economical characteristics could account for differences in the estimated incidence among areas. However, diferences in the quality indicators suggest that a validation study with standardized diagnostic criteria will make quality evaluation of the algorithm possible.
定义一种算法并在意大利各地区实施，以便通过现有数据库评估急性卒中发病率。
拉齐奥、托斯卡纳、威尼斯AULSS 12、都灵ASL 5。
上述4个地区2002 - 2004年的常住人口。
按性别和年龄组（0 - 14岁、15 - 34岁、35 - 54岁、55 - 64岁、65 - 74岁、75 - 84岁、85岁及以上）划分的年度和三年发病率（粗发病率和每10万居民的标准化发病率，95%置信区间），按性别和地区划分的标准化死亡率。
通过住院数据库（SDO）和死亡原因（CM）确定2002 - 2004年意大利4个地区的急性卒中发病病例。选择范围包括住院病例（不包括门诊病例）以及在过去60个月内没有因卒中诊断住院的出院或死亡编码为ICD9 - CM 430*、431*、434*、436的死者。此外，排除次要诊断编码为438的患者以及从康复或长期住院病房出院的患者。
男性的粗发病率高于女性（高30%）。特定年龄发病率在老年人（男性65岁及以上，女性75岁及以上）的不同地区间差异很大，托斯卡纳地区男女发病率均较高（每10万居民病例数：男性260.1；女性193.1）。都灵和拉齐奥地区发病率处于中间值；威尼斯地区发病率最低（男性：182.5；女性：136.8）。标准化死亡率在两个大区（拉齐奥和托斯卡纳）也呈现较高水平，在两个城市地区（都灵和威尼斯）较低。
评估该算法并非易事。结果似乎与其他研究足够相符，并且与当前死亡率数据具有一定的一致性。不同的社会经济特征可能是各地区估计发病率存在差异的原因。然而，质量指标的差异表明，采用标准化诊断标准进行验证研究将使对该算法的质量评估成为可能。
