| 1. |
- Engström, Gunnar, et al.
(författare)
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Marital Dissolution Is Followed by an Increased Incidence of Stroke.
- 2004
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1421-9786 .- 1015-9770. ; 18:4, s. 318-324
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Many studies have reported lower mortality in married people. The relation between marital status and incidence of haemorrhagic and ischaemic stroke is unclear. It is largely unknown whether the risk of stroke is increased the first years after divorce or death of spouse. <i>Methods:</i> Incidence of first-ever stroke (n = 6,184) was followed over 10 years in a cohort consisting of all 40- to 89-year-old inhabitants (n = 118,134) in the city of Malmö, Sweden. Marital dissolution (i.e. divorce or death of spouse) prior to the date of stroke was compared in a nested case-control design (3,134 initially married stroke cases, 9,402 initially married controls). <i>Results:</i> As compared to the married groups, the incidence of stroke was increased in divorced men and women (RR = 1.23, CI: 1.10–1.39 and RR = 1.26, CI: 1.12–1.41, respectively) and widowed men and women (RR = 1.13, CI: 0.99–1.28 and RR = 1.13, CI: 1.02–1.24, respectively) after adjustments for age, country of birth and socioeconomic indicators. The risk of stroke was not increased in never married men. Marital dissolution was followed by increased risk of stroke, which was significant for men (adjusted odds ratio: 1.23, CI: 1.03–1.5) and borderline significant for women below 65 years of age (odds ratio: 1.45, CI: 0.99–2.14). <i>Conclusion:</i> The incidence of stroke is increased in divorced and widowed individuals. Never married men do not have an increased incidence. The risk of stroke is elevated during the first years after divorce or death of spouse.
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| 2. |
- Merlo, Juan, et al.
(författare)
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Comparison of different procedures to identify probable cases of myocardial infarction and stroke in two Swedish prospective cohort studies using local and national routine registers
- 2000
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Ingår i: European Journal of Epidemiology. - 1573-7284. ; 16:3, s. 235-243
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Tidskriftsartikel (refereegranskat)abstract
- In prospective cohort studies, person-time time is calculated from baseline until the first definite event occurs or until censoring. A way to correctly identify and date definite events when only routine registers are available is to retrieve all hospital discharge notes and death certificates with a diagnosis of probable event and perform a consecutive revision. It is important to detect all possible hospital stays as they may contain useful information for the revision study. Furthermore, loss to follow-up can be avoided by extending the retrieval outside the specific geographical area where the cohort was defined. The aims of this study were (i) to describe a comprehensive retrieval of probable myocardial infarctions (diagnosis with International Classification of Diseases 8th and 9th revisions codes 410-414) or stroke (codes 430-438), (ii) to quantify the relative efficiency of different local and national routine registers or their combination compared with the use of all available registers together, and (iii) to audit local and national registers by comparing their outcome at the county level. The study was performed in two prospective cohorts studies i.e., 'Men-born-1914' (n = 500) from Skane (period 1982-1993), and Skara-1 (n = 683) from Skaraborg (period 1988-1994.). All available routine registers were linked to the cohorts. The use of all available routine registers improved retrieval of both individual and hospital stays with a discharge diagnosis of probable event and gave an enhanced basis for a future validation study. Local registers were not completely covered by the national register, but the accessible combination of national inpatient and mortality registers was an efficient alternative.
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| 3. |
- Pessah-Rasmussen, Hélène, et al.
(författare)
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Increasing stroke incidence and decreasing case fatality, 1989-1998: a study from the stroke register in Malmö, Sweden.
- 2003
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 34:4, s. 913-918
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Although the incidence of and mortality from myocardial infarction (MI) have declined in most industrialized countries, incidence studies of stroke have shown less consistent trends. This study examines time trends in the incidence of stroke and case fatality rates in relation to socioeconomic circumstances and history of MI.METHODS: Stroke incidence in the city of Malmö, Sweden (250,000 citizens), has been continuously monitored since 1989. All patients 50 to 79 years of age who experienced a first-ever stroke between 1989 and 1998 were included.RESULTS: We included 3621 patients (1969 men, 1652 women). The age-standardized incidence was 647 per 100,000 persons-years for men and 400 per 100,000 persons-years for women. The annual increase-3.1% in men (P<0.05) and 2.9% in women (P<0.05)-was more pronounced in the younger age groups and was lowest in areas with poor socioeconomic circumstances. We found that 13% of the men and 6% of the women had a history of MI; this proportion was stable over the study period. The average case fatality rates in 1989 to 1998 were 10% for men and 9.3% for women. Rates remained stable for men but declined significantly in women (odds ratio per year, 0.895; 95% confidence interval, 0.84 to 0.95).CONCLUSIONS: In this urban population, stroke incidence increased between 1989 and 1998. The rate of increase tended to be lower in residential areas with least favorable socioeconomic circumstances. The proportion with a history of MI remained unchanged during the study period. There has been significant improvement in the case fatality rate in women but not in men.
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