Díaz-Guzmán J, Egido-Herrero J A, Gabriel-Sánchez R, Barberà G, Fuentes B, Fernández-Pérez C, Abilleira S
Hospital Universitario 12 de Octubre, Madrid, España.
Rev Neurol. 2008;47(12):617-23.
Epidemiological data on the incidence of cerebrovascular diseases in our country are scarce. A representative population-based study with a large denominator is required.
To present the design of the study on stroke incidence in Spain, entitled Iberictus.
We conducted a prospective, population-based study on the incidence of strokes and transient ischemic attacks, in which it is possible to distinguish: 1) population with a steady risk, which was well defined and had a broad denominator. We included all the cases in which the first episode of acute cerebrovascular disease was diagnosed among those over the age of 17 years (with no upper age limit) with their habitual residence in the areas of study between the 1st January and 31st December 2006: Lugo, Segovia, Talavera de la Reina, Mallorca and Almeria (total denominator, 1,440,997 inhabitants; minimum denominator per area, 100,000 inhabitants); 2) source of multiple and complementary data: hospital records (minimum basic data set, discharge abstracts), emergency and primary care records for the area with diagnostic codes 430-39 and 674.0 (International Classification of Diseases-9), population-based mortality records; 3) standardised definitions: diagnostic categorisation (MONICA-World Health Organisation, 1987), pathological classification (ischaemia, haemorrhagic), topography and aetiology; 4) presentation of data in suitable age groups, by sex and overall; 5) pilot study and analysis of inter-observer agreement among researchers.
With this design, the Iberictus study satisfies the methodological criteria as an 'ideal' study of the incidence of acute cerebrovascular diseases proposed by Malgrem, Sudlow and Warlow, and represents a unique opportunity to further our knowledge of the epidemiology of strokes in our country.
我国脑血管疾病发病率的流行病学数据匮乏。需要开展一项以具有大量分母的代表性人群为基础的研究。
介绍西班牙一项名为伊比利亚卒中（Iberictus）的卒中发病率研究的设计。
我们开展了一项关于卒中和短暂性脑缺血发作发病率的前瞻性、基于人群的研究，在此研究中能够区分：1）风险稳定的人群，该人群定义明确且分母范围广泛。我们纳入了所有在2006年1月1日至12月31日期间，年龄在17岁以上（无年龄上限）且常住于研究区域（卢戈、塞哥维亚、塔拉韦拉德拉雷纳、马略卡和阿尔梅里亚）的急性脑血管疾病首次发作病例（总分母为1,440,997名居民；每个区域的最小分母为100,000名居民）；2）多个互补数据来源：医院记录（最小基本数据集，出院摘要）、该区域诊断编码为430 - 39和674.0（国际疾病分类第9版）的急诊和初级保健记录、基于人群的死亡率记录；3）标准化定义：诊断分类（世界卫生组织莫尼卡方案，1987年）、病理分类（缺血性、出血性）、部位和病因；4）按合适的年龄组、性别和总体呈现数据；5）进行预试验并分析研究人员之间的观察者间一致性。
通过这种设计，伊比利亚卒中研究满足了马尔格雷姆、萨德洛和沃洛提出的作为急性脑血管疾病发病率“理想”研究的方法学标准，并且为增进我国卒中流行病学知识提供了一个独特的机会。
