International Journal of Epidemiology, Vol 28, 1059-1065, Copyright © 1999 by International Epidemiological Association
Y Kita, A Okayama, H Ueshima, M Wada, A Nozaki, SR Choudhury, R Bonita, Y Inamoto and T Kasamatsu
BACKGROUND: This paper describes incidence rates and case-fatality for
sub-types of stroke using data collected in Takashima, Shiga, Japan, from
1989 to 1993 and compares these with similar registers in other parts of
Japan. METHODS: Registered patients included all residents of the county
who experienced a first-ever stroke. Stroke was defined as sudden onset of
neurological symptoms which continued for a minimum of 24 hours or led to
death. Almost all such patients are hospitalized in this country. Early
case fatality was defined as patients who died within 28 days of stroke
onset. Diagnosis of stroke type was based on clinical symptoms as well as
computed tomography (CT) scans. RESULTS: Age-adjusted incidence rates for
stroke per 100,000 population aged 35 years and older were 268.7 for men
and 167.5 for women. The age- specific incidence rate of both cerebral
infarction and cerebral haemorrhage increased with advancing age. The
occurrence of cerebral infarction in men was twice as high as in women. The
28-day case fatality for all sub-types of stroke was 16.1% in men and 15.8%
in women. Case fatality for cerebral infarction, cerebral haemorrhage, and
subarachnoid haemorrhage was 10.7%, 22.4% and 28.6% respectively.
CONCLUSIONS: Takashima County has a moderately high stroke incidence rate
and case fatality compared with other similar studies in Japan. The
incidence rate of cerebral infarction in men is twice that in women, while
other sub-types of stroke showed smaller differences. In order to decrease
the incidence of stroke in Japan, greater efforts at primary prevention
will be necessary, in particular, it is important to prevent cerebral
infarction in men.
Stroke incidence and case fatality in Shiga, Japan 1989-1993
Department of Health Science, Shiga University of Medical Science, Seta, Otsu, Japan. kita@sums.shig-med.ac.jp
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