Stroke incidence on the east coast of Australia - The North East MelbourneStroke Incidence Study (NEMESIS)

Background and Purpose-Community-based stroke incidence studies are the mos t accurate way of explaining mortality trends and developing public health policy. The purpose of this study was to determine the incidence of stroke in a geographically defined region of Melbourne, Australia. Methods-All suspected strokes occurring in a population of 133 816 resident s in suburbs north and east of Melbourne, Australia, during a 12-month peri od of 1996 and 1997 were found and assessed. Multiple overlapping sources w ere used to ascertain cases, and standard definitions and criteria for stro ke and case fatality were used. Results-A total of 381 strokes occurred among 353 people during the study p eriod, 276 (72%) of which were first-ever-in-a-lifetime strokes. The crude annual incidence rate (first-ever strokes) was 206 (95% CI, 182 to 231) per 100 000 per year overall, 195 (95% CI, 161 to 229) for males, and 217 (95% CI, 182 to 252) for females. The corresponding rates adjusted to the "worl d" population were 100 (95% CI, 80 to 119) overall, 113 (95% CI, 92 to 134) for males, and 89 (95% CI, 70 to 107) for females. The 28-day case fatalit y rate for first-ever strokes was 20% (95% CI, 16% to 25%). Conclusions-The incidence rate of stroke in our population-based study is s imilar to that of many European studies but is significantly higher than th at observed on the west coast of Australia.