Stroke incidence and outcomes in northeastern greece the evros stroke registry

Georgios Tsivgoulis, Athanasia Patousi, Maria Pikilidou, Theodosis Birbilis, Aristeidis H. Katsanos, Michalis Mantatzis, Aristeidis Asimis, Nikolaos Papanas, Panagiotis Skendros, Aikaterini Terzoudi, Aikaterini Karamanli, Ioannis Kouroumichakis, Pantelis Zebekakis, Efstratios Maltezos, Charitomeni Piperidou, Konstantinos Vadikolias, Ioannis Heliopoulos

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background and Purpose-Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of frst-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. Methods-Adult patients with frst-ever stroke were registered during a 24-month period (2010-2012) and followed up for 12 months. To compare our stroke incidence with that observed in other studies, we standardized our incidence rate data according to the European Standard Population, World Health Organization, and Segi population. We also applied criteria of data quality proposed by the Monitoring Trends and Determinants in Cardiovascular Disease project. Stroke diagnosis and classifcation were performed using World Health Organization criteria on the basis of neuroimaging and autopsy data. Results-We prospectively documented 703 stroke cases (mean age: 75±12 years; 52.8% men; ischemic stroke: 80.8%; intracerebral hemorrhage: 11.8%; subarachnoid hemorrhage: 4.4%; undefned: 3.0%) with a total follow-up time of 119805 person-years. The unadjusted and European Standard Population-adjusted incidences of all strokes were 586.8 (95% confdence interval [CI], 543.4-630.2) and 534.1 (95% CI, 494.6-573.6) per 100000 person-years, respectively. The unadjusted incidence rates for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were 474.1 (95% CI, 435-513), 69.3 (95% CI, 54-84), and 25.9 (95% CI, 17-35) per 100000 person-years, respectively. The corresponding European Standard Population-adjusted incidence rates per 100000 person-years were 425.9 (95% CI, 390.9-460.9), 63.3 (95% CI, 49.7-76.9), and 25.8 (95% CI, 16.7-34.9) for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, respectively. The overall 28-day case fatality rate was 21.3% (95% CI, 18.3%-24.4%) for all strokes and was higher in hemorrhagic strokes than ischemic stroke (40.4%, 95% CI, 31.3%-49.4% versus 16.2%, 95% CI, 13.2%-19.2%). Conclusions-This is the largest to date population-based study in Greece documenting one of the highest stroke incidences ever reported in South Europe, highlighting the need for effcient stroke prevention and treatment strategies in Northeastern Greece.

Original languageEnglish (US)
Pages (from-to)288-295
Number of pages8
JournalStroke
Volume49
Issue number2
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Fingerprint

Greece
Registries
Stroke
Incidence
Cerebral Hemorrhage
Subarachnoid Hemorrhage
Population
Neuroimaging
Autopsy

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Tsivgoulis, G., Patousi, A., Pikilidou, M., Birbilis, T., Katsanos, A. H., Mantatzis, M., ... Heliopoulos, I. (2018). Stroke incidence and outcomes in northeastern greece the evros stroke registry. Stroke, 49(2), 288-295. https://doi.org/10.1161/STROKEAHA.117.019524

Stroke incidence and outcomes in northeastern greece the evros stroke registry. / Tsivgoulis, Georgios; Patousi, Athanasia; Pikilidou, Maria; Birbilis, Theodosis; Katsanos, Aristeidis H.; Mantatzis, Michalis; Asimis, Aristeidis; Papanas, Nikolaos; Skendros, Panagiotis; Terzoudi, Aikaterini; Karamanli, Aikaterini; Kouroumichakis, Ioannis; Zebekakis, Pantelis; Maltezos, Efstratios; Piperidou, Charitomeni; Vadikolias, Konstantinos; Heliopoulos, Ioannis.

In: Stroke, Vol. 49, No. 2, 01.01.2018, p. 288-295.

Research output: Contribution to journalArticle

Tsivgoulis, G, Patousi, A, Pikilidou, M, Birbilis, T, Katsanos, AH, Mantatzis, M, Asimis, A, Papanas, N, Skendros, P, Terzoudi, A, Karamanli, A, Kouroumichakis, I, Zebekakis, P, Maltezos, E, Piperidou, C, Vadikolias, K & Heliopoulos, I 2018, 'Stroke incidence and outcomes in northeastern greece the evros stroke registry', Stroke, vol. 49, no. 2, pp. 288-295. https://doi.org/10.1161/STROKEAHA.117.019524
Tsivgoulis G, Patousi A, Pikilidou M, Birbilis T, Katsanos AH, Mantatzis M et al. Stroke incidence and outcomes in northeastern greece the evros stroke registry. Stroke. 2018 Jan 1;49(2):288-295. https://doi.org/10.1161/STROKEAHA.117.019524
Tsivgoulis, Georgios ; Patousi, Athanasia ; Pikilidou, Maria ; Birbilis, Theodosis ; Katsanos, Aristeidis H. ; Mantatzis, Michalis ; Asimis, Aristeidis ; Papanas, Nikolaos ; Skendros, Panagiotis ; Terzoudi, Aikaterini ; Karamanli, Aikaterini ; Kouroumichakis, Ioannis ; Zebekakis, Pantelis ; Maltezos, Efstratios ; Piperidou, Charitomeni ; Vadikolias, Konstantinos ; Heliopoulos, Ioannis. / Stroke incidence and outcomes in northeastern greece the evros stroke registry. In: Stroke. 2018 ; Vol. 49, No. 2. pp. 288-295.
@article{9c0f795855254d85b4ebe793ade14471,
title = "Stroke incidence and outcomes in northeastern greece the evros stroke registry",
abstract = "Background and Purpose-Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of frst-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. Methods-Adult patients with frst-ever stroke were registered during a 24-month period (2010-2012) and followed up for 12 months. To compare our stroke incidence with that observed in other studies, we standardized our incidence rate data according to the European Standard Population, World Health Organization, and Segi population. We also applied criteria of data quality proposed by the Monitoring Trends and Determinants in Cardiovascular Disease project. Stroke diagnosis and classifcation were performed using World Health Organization criteria on the basis of neuroimaging and autopsy data. Results-We prospectively documented 703 stroke cases (mean age: 75±12 years; 52.8{\%} men; ischemic stroke: 80.8{\%}; intracerebral hemorrhage: 11.8{\%}; subarachnoid hemorrhage: 4.4{\%}; undefned: 3.0{\%}) with a total follow-up time of 119805 person-years. The unadjusted and European Standard Population-adjusted incidences of all strokes were 586.8 (95{\%} confdence interval [CI], 543.4-630.2) and 534.1 (95{\%} CI, 494.6-573.6) per 100000 person-years, respectively. The unadjusted incidence rates for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were 474.1 (95{\%} CI, 435-513), 69.3 (95{\%} CI, 54-84), and 25.9 (95{\%} CI, 17-35) per 100000 person-years, respectively. The corresponding European Standard Population-adjusted incidence rates per 100000 person-years were 425.9 (95{\%} CI, 390.9-460.9), 63.3 (95{\%} CI, 49.7-76.9), and 25.8 (95{\%} CI, 16.7-34.9) for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, respectively. The overall 28-day case fatality rate was 21.3{\%} (95{\%} CI, 18.3{\%}-24.4{\%}) for all strokes and was higher in hemorrhagic strokes than ischemic stroke (40.4{\%}, 95{\%} CI, 31.3{\%}-49.4{\%} versus 16.2{\%}, 95{\%} CI, 13.2{\%}-19.2{\%}). Conclusions-This is the largest to date population-based study in Greece documenting one of the highest stroke incidences ever reported in South Europe, highlighting the need for effcient stroke prevention and treatment strategies in Northeastern Greece.",
author = "Georgios Tsivgoulis and Athanasia Patousi and Maria Pikilidou and Theodosis Birbilis and Katsanos, {Aristeidis H.} and Michalis Mantatzis and Aristeidis Asimis and Nikolaos Papanas and Panagiotis Skendros and Aikaterini Terzoudi and Aikaterini Karamanli and Ioannis Kouroumichakis and Pantelis Zebekakis and Efstratios Maltezos and Charitomeni Piperidou and Konstantinos Vadikolias and Ioannis Heliopoulos",
year = "2018",
month = "1",
day = "1",
doi = "10.1161/STROKEAHA.117.019524",
language = "English (US)",
volume = "49",
pages = "288--295",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Stroke incidence and outcomes in northeastern greece the evros stroke registry

AU - Tsivgoulis, Georgios

AU - Patousi, Athanasia

AU - Pikilidou, Maria

AU - Birbilis, Theodosis

AU - Katsanos, Aristeidis H.

AU - Mantatzis, Michalis

AU - Asimis, Aristeidis

AU - Papanas, Nikolaos

AU - Skendros, Panagiotis

AU - Terzoudi, Aikaterini

AU - Karamanli, Aikaterini

AU - Kouroumichakis, Ioannis

AU - Zebekakis, Pantelis

AU - Maltezos, Efstratios

AU - Piperidou, Charitomeni

AU - Vadikolias, Konstantinos

AU - Heliopoulos, Ioannis

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Purpose-Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of frst-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. Methods-Adult patients with frst-ever stroke were registered during a 24-month period (2010-2012) and followed up for 12 months. To compare our stroke incidence with that observed in other studies, we standardized our incidence rate data according to the European Standard Population, World Health Organization, and Segi population. We also applied criteria of data quality proposed by the Monitoring Trends and Determinants in Cardiovascular Disease project. Stroke diagnosis and classifcation were performed using World Health Organization criteria on the basis of neuroimaging and autopsy data. Results-We prospectively documented 703 stroke cases (mean age: 75±12 years; 52.8% men; ischemic stroke: 80.8%; intracerebral hemorrhage: 11.8%; subarachnoid hemorrhage: 4.4%; undefned: 3.0%) with a total follow-up time of 119805 person-years. The unadjusted and European Standard Population-adjusted incidences of all strokes were 586.8 (95% confdence interval [CI], 543.4-630.2) and 534.1 (95% CI, 494.6-573.6) per 100000 person-years, respectively. The unadjusted incidence rates for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were 474.1 (95% CI, 435-513), 69.3 (95% CI, 54-84), and 25.9 (95% CI, 17-35) per 100000 person-years, respectively. The corresponding European Standard Population-adjusted incidence rates per 100000 person-years were 425.9 (95% CI, 390.9-460.9), 63.3 (95% CI, 49.7-76.9), and 25.8 (95% CI, 16.7-34.9) for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, respectively. The overall 28-day case fatality rate was 21.3% (95% CI, 18.3%-24.4%) for all strokes and was higher in hemorrhagic strokes than ischemic stroke (40.4%, 95% CI, 31.3%-49.4% versus 16.2%, 95% CI, 13.2%-19.2%). Conclusions-This is the largest to date population-based study in Greece documenting one of the highest stroke incidences ever reported in South Europe, highlighting the need for effcient stroke prevention and treatment strategies in Northeastern Greece.

AB - Background and Purpose-Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of frst-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. Methods-Adult patients with frst-ever stroke were registered during a 24-month period (2010-2012) and followed up for 12 months. To compare our stroke incidence with that observed in other studies, we standardized our incidence rate data according to the European Standard Population, World Health Organization, and Segi population. We also applied criteria of data quality proposed by the Monitoring Trends and Determinants in Cardiovascular Disease project. Stroke diagnosis and classifcation were performed using World Health Organization criteria on the basis of neuroimaging and autopsy data. Results-We prospectively documented 703 stroke cases (mean age: 75±12 years; 52.8% men; ischemic stroke: 80.8%; intracerebral hemorrhage: 11.8%; subarachnoid hemorrhage: 4.4%; undefned: 3.0%) with a total follow-up time of 119805 person-years. The unadjusted and European Standard Population-adjusted incidences of all strokes were 586.8 (95% confdence interval [CI], 543.4-630.2) and 534.1 (95% CI, 494.6-573.6) per 100000 person-years, respectively. The unadjusted incidence rates for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were 474.1 (95% CI, 435-513), 69.3 (95% CI, 54-84), and 25.9 (95% CI, 17-35) per 100000 person-years, respectively. The corresponding European Standard Population-adjusted incidence rates per 100000 person-years were 425.9 (95% CI, 390.9-460.9), 63.3 (95% CI, 49.7-76.9), and 25.8 (95% CI, 16.7-34.9) for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, respectively. The overall 28-day case fatality rate was 21.3% (95% CI, 18.3%-24.4%) for all strokes and was higher in hemorrhagic strokes than ischemic stroke (40.4%, 95% CI, 31.3%-49.4% versus 16.2%, 95% CI, 13.2%-19.2%). Conclusions-This is the largest to date population-based study in Greece documenting one of the highest stroke incidences ever reported in South Europe, highlighting the need for effcient stroke prevention and treatment strategies in Northeastern Greece.

UR - http://www.scopus.com/inward/record.url?scp=85044034083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044034083&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.117.019524

DO - 10.1161/STROKEAHA.117.019524

M3 - Article

VL - 49

SP - 288

EP - 295

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 2

ER -