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Temporal trends in stroke incidence and case-fatality rates in Arcadia, Greece: A sequential, prospective, population-based study

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Eleni Karantali, Konstantinos Vemmos, Evangelos Tsampalas, Konstantinos Xynos, Persefoni Karachalia, Dimitrios Lambrou, Stella Angeloglou, Maria Kazakou, Aikaterini Karagianni, Konstantina Aravantinou-Fatorou, Eleftheria Karakatsani, Michiel L. Bots, Georgia Karamatzianni, Stavros Bellos, Romanos Ntiloudis, Maria Lypiridou, Anastasia Gamvoula, Georgios Georgiopoulos, Erold Ajdini, Nikolaos Gatselis & 3 more Konstantinos Makaritsis, Eleni Korompoki, George Ntaios

Original languageEnglish
Pages (from-to)37-47
Number of pages11
JournalInternational Journal Of Stroke
Issue number1
Accepted/In press2021
PublishedJan 2022

Bibliographical note

Funding Information: The authors thank the doctors, nurses, and the administrative staff of the Arcadia General Hospital, the local health centers, and the Private Practitioners for their help in conducting these studies. They also thank the patients and their families for their contribution. The author(s) received no financial support for the research, authorship, and/or publication of this article. Publisher Copyright: © 2021 World Stroke Organization.

King's Authors


Background: Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. Aims: The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. Methods: All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015–2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. Results: In total, 1315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100,000 person-years (95% CI 231–239) in 1993/1995, 252 (95% CI 223–286) in 2004, and 211 (192–232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95% CI: 0.72–0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio = 0.72, 95% CI: 0.58–0.90). Conclusions: This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.

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