It is important that we have reliable information about the number of people across Europe who have a stroke and what happens to them. What services and support do they get? To what extent do they recover? How well are health and social services doing and how do we improve outcomes? What is the economic impact of stroke on individuals and also on society? What resources are needed to make sure everyone who has a stroke gets the help they need?
The way that information about stroke is gathered varies widely across Europe and there are pros and cons about different sets of information. National stroke registers and audits (e.g. in Austria, Denmark, Finland, Germany, Hungary, Ireland, Israel, Poland, Sweden, UK) are a rich source of information but generally only pick up hospitalised patients. So, for example, while 85% of cases are picked up in this way in Finland, Sweden and Denmark; in Poland less than 40% of stroke patients are included.
Population based registers, looking only at a smaller geographical area, overcome this problem by including reports from general practitioners (GPs) and outpatient departments, for example, and also have the advantage of providing the potential to measure the longer term outcomes of stroke survivors.
For this report, various types of data have been used. Most studies differ in their epidemiological and statistical methods, so comparing between them has to be done carefully. This report aims to present the most comparable data from different countries in order to show trends across Europe.
THE MOST COMMON MEASURES USED ARE:
Incidence – the number of new strokes.
The incidence of stroke depends on risk factors that can’t be changed, such as age, and risk factors that are modifiable, such as high blood pressure or smoking. The number of people having a stroke is, therefore, influenced by prevention measures.
Mortality – the number of people who die as a result of their stroke.
This is linked to how severe someone’s stroke is, but also to the quality of stroke care, particularly acute stroke care. Measuring “case fatality” (the number of stroke deaths within a month of having the stroke), is strongly linked to the provision of emergency and acute stroke care.
Prevalence – the number of stroke survivors in the population.
The number of stroke survivors captures stroke as a long-term condition and points to the level of rehabilitation needs that should be met.
Disability Adjusted Life Years lost (DALYs lost):
Combines morbidity (the number of years lived with a certain level of disability) and mortality, thereby estimating the number of healthy life-years lost in a population due to an illness. It is useful for measuring the long-term societal burden of stroke.