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Published on: August 18, 2015
First-Ever Stroke and Transient Ischemic Attack Incidence and 30-Day Case-Fatality Rates in a Population-Based Study
M Cecilia Bahit1, Mariano L Coppola1, Patricia M Riccio1
1From the INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina (M.C.B.); Hospital Santamarina, Tandil, Buenos Aires, Argentina (M.L.C., M.D.M., A.D., M.L.L., R.M., C.M., G.O., D.S., A.U.); Department of Clinical Neurological Sciences, London Health Sciences Centre, and London Heart & Brain Research Program, Western University, London, Ontario (P.M.R., L.A.S.); Ivey Business School, Western University, London, Ontario, Canada (L.E.C.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (G.A.R.); Duke University Medical Center, Duke Clinical Research Institute, Durham, NC (R.D.L.); Faculty of Health and Environmental Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand (V.L.F.); Sanatorio Tandil, Tandil, Buenos Aires, Argentina (B.B.G., D.M.); Argentinean Ministry of Health (D.F.); Nueva Clínica Chacabuco, Tandil, Buenos Aires, Argentina (F.F., P. Macarrone, P. Martínez, R.S.); Servicio de Neurología, Clínica Alemana, Centro de Neurociencias, Universidad del Desarrollo, Santiago, Chile and Departamento de Ciencias Neurológicas, Universidad de Chile (P.L.); Department of Neurology, Mayo Clinic, Rochester, MN (A.A.R.); Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Rigshospitalet, Copenhagen, Denmark (T.T.); and Círculo Médico, Tandil, Buenos Aires, Argentina (D.H.L., C.A.V.).
Background And Purpose:
Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina.
Methods:
We prospectively identified all first-ever stroke and TIA cases from overlapping sources between January 5, 2013, and April 30, 2015, in Tandil, Argentina. We calculated crude and standardized incidence rates. We estimated 30-day case-fatality rates.
Results:
We identified 334 first-ever strokes and 108 TIAs. Age-standardized incidence rate per 100 000 for Segi's World population was 76.5 (95% confidence interval [CI], 67.8-85.9) for first-ever stroke and 25.1 (95% CI, 20.2-30.7) for first-ever TIA, 56.1 (95% CI, 48.8-64.2) for ischemic stroke, 13.5 (95% CI, 9.9-17.9) for intracerebral hemorrhage, and 4.9 (95% CI, 2.7-8.1) for subarachnoid hemorrhage. Stroke incidence was slightly higher for men (87.8; 95% CI, 74.6-102.6) than for women (73.2; 95% CI, 61.7-86.1) when standardized for the Argentinean population. Thirty-day case-fatality rate was 14.7% (95% CI, 10.8-19.5) for ischemic stroke, 24.1% (95% CI, 14.2-36.6) for intracerebral hemorrhage, and 1.9% (95% CI, 0.4-5.8) for TIA.
Conclusions:
This study provides the first prospective population-based stroke and TIA incidence and case-fatality estimate in Argentina. First-ever stroke incidence was lower than that reported in previous Latin-American studies, but first-ever TIA incidence was higher. Thirty-day case-fatality rates were similar to those of other population-based Latin-American studies.
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