Incidence and prognosis of stroke in the Belluno province, Italy. First-year results of a community-based study

BACKGROUND AND PURPOSE

We sought to register the incidence rate, risk factors, and case-fatality rate of all the new cases of first-ever-in-a-lifetime stroke in the province of Beluno, Italy. This study aimed to provide an epidemiological survey of cerebrovascular disease that could supply investigative objectives and support information for regional healthcare facilities planning.

METHODS

We undertook a prospective population-based study in the territory of the 1st, 2nd, 3rd, and 4th local health units in the province of Belluno, an area located in northeast Italy (population, 211 389).

RESULTS

In the first year of the study (June 1, 1992, to May 31, 1993), 474 cases of first-ever stroke were registered. The crude annual incidence rate was 2.24/1000 (2.01/1000 for men and 2.45/1000 for women). After adjustment to the European population, the incidence rate for first stroke was 1.70/1000 per year. The pathological diagnosis was confirmed by a CT scan in 89.5% of cases. Cerebral infarction accounted for 319 cases, while 93 patients suffered a primary intracerebral hemorrhage, 12 patients a subarachnoid hemorrhage, and 50 patients a stroke of unknown origin. The overall 30-day case-fatality rate was 33%, and the mortality within the first week from stroke onset was 23%. The recurrence rate after 1 month was 1.9%. After 1 month, 46% of our patients were functionally independent in activities of daily living.

CONCLUSIONS

Our first-year results confirm the fairly high risk for stroke in central and northern Italy and support European findings regarding risk factors for stroke.

Incidence of transient global amnesia in the Belluno province, Italy: 1985 through 1995. Results of a community-based study

INTRODUCTION

We sought to determine the incidence rate of all the new cases of first-ever-in-a-lifetime transient global amnesia in the Belluno province, Italy. Only two prospective epidemiological studies on TGA incidence have been performed to date, non in Italy. Our study aimed to provide reliable and comparable information on TGA incidence.

MATERIAL AND METHODS

We undertook a prospective population-based study in the territory of the province of Bulluno, Italy, between June 1, 1992 and December 31, 1995. We also retrospectively reviewed the clinical records of all the patients with a diagnosis of amnesia seen in the hospitals of the study area from January 1, 1985 through May 31, 1992.

RESULTS

During the prospective study period we identified 77 patients who experienced a first-ever TGA. The crude annual incidence rate was 10.4/100,000 (9.35/100,000 for men and 11.37/100,000 for women). After adjustment to the European population, the incidence rate decreased to 8.60/100,000 per year. The crude annual incidence rate during the retrospective study period was 5.81/100,000. The demographic and clinical features of the two groups did not differ one to the other.

CONCLUSIONS

The incidence rate of first-ever TGA registered in the province of Belluno, Italy, was closely similar to that reported in Turku, Finland and confirms that TGA is more common than has been usually proposed. We emphasize the usefulness of prospective, rather than retrospective, epidemiological studies for research on TGA.

Transient global amnesia and transient ischemic attack: a community-based case-control study

OBJECTIVES

Few case-control studies of first-ever transient global amnesia (TGA), transient ischemic attack (TIA) and normal controls have been performed to date. We aimed to assess the prevalence of cerebrovascular risk factors in a well defined population of TGA patients.

MATERIAL AND METHODS

We undertook a retrospective and prospective community-based case-control study of 170 first-ever TGA, 170 first-ever TIA and 170 normal controls.

RESULTS

Age-matched analysis revealed that TGA cases had a significantly lower prevalence of atrial fibrillation and diabetes mellitus than TIA controls. The prevalence of cigarette smoking and diabetes mellitus was significantly higher in normal controls than in TGA cases.

CONCLUSION

Our community-based case-control study showed that atrial fibrillation and diabetes mellitus, two important risk factors for cerebrovascular disease, were significantly more common in the TIA group than in the TGA one. These results make the thromboembolic pathogenesis of TGA unlikely.

Incidence of transient ischemic attacks in the Belluno Province, Italy. First-year results of a community-based study

OBJECTIVES

This study formed part of a larger prospective population-based survey on cerebrovascular diseases and aimed to provide reliable and comparable results on TIA incidence and on related risk factors, which could supply investigation objectives and support information for primary and secondary prevention.

MATERIAL AND METHODS

We undertook a prospective population-based study in the province of Belluno, an area located in the North-East of Italy where 211,389 people live, utilizing all the possible case-collection sources available in the territory.

RESULTS

In the first year of the study (June 1, 1992 to May 31, 1993) 271 patients with a diagnosis of transient ischemic attack were recruited. Among these, we recorded 171 cases of new TIAs. The crude annual incidence rate for new TIAs was 0.80 per 1000, 0.73 per 1000 for men and 0.87 per 1000 for women. After adjustment to the European population, the overall incidence rate decreased to 0.58 per 1000 inhabitants per year. The mean age of new TIA patients was 73.91 years and females were significantly older than males (p < 0.001). A CT scan disclosed an infarct in 21 new TIA patients.

CONCLUSION

Our first-year results on new TIAs incidence did not differ from the findings reported in previous population-based studies performed throughout the world and support data as to risk factors for TIA.