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

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.