The Lehigh Valley Stroke Program: establishing a communitywide, hospital-based stroke register

A communitywide, hospital-based stroke register has been established in the Lehigh Valley of Pennsylvania and New Jersey. The Lehigh Valley has about 600,000 inhabitants and is geographically somewhat isolated. Ninety-five percent of the people are white, and the population has an age-sex distribution like that of the United States as a whole. All patients falling into any of nine diagnostic categories of stroke or transient ischemic attack are registered on admission to a hospital, and medical, social, and demographic data are abstracted onto precoded data forms. A single neurologist assigns definitive diagnoses according to standardized criteria after reviewing all of the medical data. The stroke register provides a new and powerful tool for collecting population-based data on a large number of cases in a short-time. After adjusting for demographic differences, epidemiologic studies can be carried out that may be generalizable to the entire United States. Several organizational aspects of the register and its operation are described in this report, and examples of the types of information and statistics readily calculable from the data in the register are given. The completeness of the stroke ascertainment and the large population registered also offer an excellent opportunity for any interested researcher to investigate the relationships between medical, social, and demographic conditions on the one hand and stroke risk on the other; to study the efficacy of prevention and treatment programs; and to determine health care provision requirements in a well-defined population.