engleski

Epidemiology of stroke

Noninfectious chronic diseases are on a constant increase as the cause of morbidity and mortality. This unfavorable tendency has been investigated in numerous studies conducted in Croatia and abroad. Epidemiology is a medical science discipline with a major task to follow up and study the occurrence, spread, course, and environmental impact of all diseases or groups of diseases known to modern medicine. Different epidemiologists use various sources of data in their studies of the epidemiology of cerebrovascular diseases (CVD), e.g.: 1) patient admission forms of those hospitalized for CVD; 2) data from death certificates which, however, may frequently contain incomplete or inaccurate data on the cause of death; 3) epidemiologic field studies are very exact, using a representative sample for a larger area; such a study requires precise methodology and may last for years or permanently; and 4) data on inpatients treated, followed-up and possibly readmitted for CVD; this source probably provides most complete data that can be combined with death certificates in case of lethal outcome. Various types of epidemiologic studies can be combined, since they actually are complementary. In the epidemiology of CVD, the interest is focused on the disease morbidity revealing its spread. A sample of 100, 1000, 10 000 or 100 000 population is usually included. Also, there is a growing interest in the risk factors for CVD. The data obtained by such epidemiologic studies can prove highly useful for future planning of health policy. In Zagreb, the first study of stroke incidence was carried out in 1971. An expert group (Marquadsen, Aho, Hatano and Poljaković) spent four years analyzing and coordinating the documentation available, and concluded that a sample of 100 000 and 20 000-25 000 population should be considered in an urban and rural area, respectively. In 1971, the Trnje Center for Cerebrovascular Diseases was founded in Zagreb. A number of valuable epidemiologic studies were performed, the last one in 1986. This study showed the CVD mortality to be on a decrease in developed countries, especially after 1970, whereas an increase continued to be recorded in less developed countries. In Croatia, CVD mortality was 7.1% in 1958, and rose to 14.9% in 1987. During that period, the mortality increased by 40% (and by 264% for CVD), similar to data from eastern Europe countries. The aim of the present study was not only to analyze mortality rate, but also to assess the dynamics of CVD in Croatia, thus to possibly help improve the CVD outcome. A stroke registry was kept at the Center, allowing analysis of stroke outcomes, however, the work on the registry had in the meantime been interrupted. It appears to be an imperative to continue with this form of follow-up in order to improve secondary and tertiary prevention of CVD. The incidence of stroke is 2-3 / 1000, while its prevalence is even higher. Stroke most commonly occurs in middle-aged and elderly individuals, its incidence increasing rapidly after the age of 50. There is no sex difference in the incidence of stroke, however, women are affected at an older age. There are no geographic or racial differences in the incidence of stroke, but there is a significant difference between urban and rural population. Stroke is associated with a high lethality of 25%-30%.

epidemiology; stroke

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