A population-based prospective 24-month study of stroke: incidence and 30-day case-fatality rates of first-ever strokes in Croatia.

BACKGROUND: In Central/Eastern European countries, cerebrovascular diseases are among the leading causes of mortality. We aimed to determine the incidence of first-ever stroke (FES) in the north-western part of Croatia. METHODS: A population-based prospective incidence study was conducted between July 1, 2007, and June 30, 2009. Cases were sought from multiple overlapping sources. Incidence rates by stroke type and gender were calculated. RESULTS: A total of 1,487 events were recorded, 1,017 of which were FESs. European age-adjusted incidence rates (per 100,000 population) were: total FESs 223.6 [women/men rate ratio (w/m RR) = 0.65 (95% CI 0.57-0.73)]; ischemic stroke 162.4 (w/m RR = 0.65, 0.56-0.76); intracerebral hemorrhage 28.4 (w/m RR = 0.44, 0.30-0.63); subarachnoid hemorrhage 7.2 (w/m RR = 1.18, 0.55-2.54); unknown etiology 25.5 (w/m RR = 0.78, 0.54-1.14). Adjusted incidence rates of ischemic strokes by subtype were: cardioembolic 52.9 (w/m RR = 0.77, 0.59-0.99); large-artery atherosclerosis 14.4 (w/m RR = 0.22, 0.13-0.38); small-artery occlusion 24.5 (w/m RR = 0.53, 0.37-0.77) and 'other or uncertain causes' 70.6 (w/m RR = 0.77, 0.62-0.97). Thirty-day case-fatality rate was 23.5% overall and 17.1% for ischemic stroke. CONCLUSIONS: The incidence of FES and 30-day mortality of patients with ischemic strokes in the studied population is higher than in Western European countries.

Higher serum triglyceride level in patients with acute ischemic stroke is associated with lower infarct volume on CT brain scans.

We investigated the relationship between serum triglyceride level and acute ischemic stroke severity using infarct volume on CT brain scans as a marker. A total of 121 consecutive acute ischemic stroke patients (53 males and 68 females, age 47-93 years) with anterior circulation (75%), posterior circulation (9%) or lacunar infarcts (16%) were examined. All patients were admitted within 24 h of the symptom onset, and CT scans were taken over the subsequent 24-72 h. With adjustment for the infarct type, age, sex, timing of CT imaging (24-36, >36-48 or >48-72 h since admission), atrial fibrillation, hypertension, fasting cholesterol and glucose levels, a higher (> or =1.70 mmol/l) fasting serum triglyceride level (within 24 h after admission) was associated with a lower infarct volume (p = 0.014). In line with a recent report on milder clinical symptoms in acute ischemic stroke patients with higher triglycerides, the results suggest an independent association between serum triglyceride level and stroke severity.

Intracranial tumors in adult population of the Varazdin County (Croatia) 1996-2004: a population-based retrospective incidence study.

AIM: To estimate the incidence of intracranial tumors in the adult population of the Varazdin County, Croatia, for the 1996-2004 period. SETTING: Varazdin County General Hospital and four university hospitals in Zagreb, the capital of Croatia. STUDY PERIOD: January 1, 1996 to December 31, 2004. Incident patients: county residents admitted for newly diagnosed intracranial tumors according to the WHO diagnostic criteria. Demographic data were extracted from the 2001 Croatian census. Incidence rates (IRs) per 100,000 person-years (p-y) and annual IRs (per 100,000 persons) were determined and compared as incidence rate ratios (IRRs) with 95% CI. RESULTS: For primary intracranial tumors (PITs), IR was 12.1/100,000 p-y (95% CI: 10.3-14.2), comparable in men and women. The highest incidence was recorded for glioblastoma (IR 4.8, 3.7-6.2) and meningioma (IR 3.1, 2.2-4.2). The incidence of PIT was somewhat greater than that of metastatic tumors (IRR 1.58, 95% CI: 1.22-2.05, P < 0.001). Metastatic tumors were more frequent in men than in women, especially metastatic lung tumors (IRR 6.08, 2.32-20.16, P < 0.001). IRs of all PIT taken together, neuroepithelial tumors cumulatively, nonepithelial tumors cumulatively, glioblastoma and meningioma were higher in the population aged > or = 40 vs. population aged < or = 39 (all IRRs with 95% CI greater than 1, P < 0.05 or < 0.001), comparable in men and women. Women were somewhat older than men at the time of diagnosis of PIT: median difference -6 years (95.1% CI: -10 to -1, P < 0.05). Annual IRs for all these tumor categories showed increasing trends over the study period. CONCLUSION: Overall, there was an increasing trend in the incidence of primary intracranial tumors in the Varazdin County. Data did not allow estimation for most of the specific tumor types.