Incidence and case-fatality of stroke on the east border of the European Union: The grodno stroke study

Background and Purpose- The epidemiology of stroke in Belarus is unclear. Therefore, a population-based register of stroke was set up in western Belarus to determine incidence and case-fatality in a defined urban population. Methods- The Grodno Stroke Study is a prospective community-based research among 311 134 residents of the city of Grodno, Belarus. Standard definitions and multiple overlapping sources of ascertainment were used to identify all cases of first-ever-in-a-lifetime strokes in all age groups occurring between January 1, 2001, and December 31, 2003. Results- During 3 years, 2069 cases of first-ever-in-a-lifetime strokes were registered. Mean age at stroke onset was 65.8±11.6 years; rate of hospitalization was 89.7%. The crude annual incidence rate of first-ever-in-a-lifetime strokes for the study period was 222 per 100 000 (95% CI, 212 to 233). Incidence adjusted to the European standard population and to the World Health Organization world standard population was 287 per 100 000 (95% CI, 274 to 301) and 220 per 100 000 (95% CI, 210 to 231), respectively. The 28-day case-fatality rate was 26.1%. The prevalence of hypertension among all first-ever-in-a-lifetime stroke patients was 87.5%; 529 (25.6%) were current smokers. A total 23.1% of patients had atrial fibrillation, 19.1% had past myocardial infarction, 14.7% had diabetes mellitus, and 22.1% had hypercholesterolemia. Conclusions- High incidence and case-fatality rates determine the considerable burden of stroke in Belarus and might at least partly be related to the high prevalence of risk factors among the population.