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

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 GatselisKonstantinos Makaritsis, Eleni Korompoki, George Ntaios*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Pages (from-to)37-47
Number of pages11
JournalInternational Journal of Stroke
Issue number1
Early online date24 Feb 2021
Publication statusPublished - Jan 2022


  • case-fatality
  • epidemiology
  • Greece
  • incidence
  • population-based study
  • Stroke


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