Objective: To analyse the trends and distributions of case-fatality within 28 days after stroke in the population aged 35 - 74 in Beijing from 1984 to 2000 and to explore the possible influencing factors for case-fatality.
Methods: In Sino-MONICA Project, acute stroke events were registered in a standardized way in men and women aged 35 - 74 years in Beijing from 1984 to 2000. Death even was defined as death within 28 days after stroke onset. From January 1 1984 to December 31 2000, 13,556 patients were registered, and 3905 died within 28 days of stroke onset.
Results: (1) The overall case-fatality within 28 days after stroke was 28.8% from 1984 to 2000, and the case-fatality were 63.2% for cerebral infarction (CI) and 34.8% for cerebral haemorrhage (CH) respectively. (2) The case-fatality for stroke declined 1.51% (P < 0.01) in men and 1.83% (P < 0.01) in women annually during 1984 to 2000, and the decline rate for CH and CI were 1.48% and 0.51% per year respectively. (3) The case-fatality ratio between men and women was 1:1.13 (P < 0.01). The case fatality for stroke was higher in rural area (38.7%) than in urban area (26.3%) (P < 0.01), and higher for recurrent stroke (36.1%) than for initial stroke (25.2%) (P < 0.01).
Conclusions: The overall 28-day case-fatality after stroke onset decreased continually in the population aged 35 - 74 in Beijing during 1984 to 2000. The biggest contribution was from the decline of case-fatality of cerebral haemorrhage of stroke. In order to decrease the incidence of stroke, promoting the quality of health care and secondary prevention for stroke will be necessary, especially in rural area.