Background & Objective: Cerebrovascular disease mortality rates have declined in some countries during recent decades. Changes in mortality rates over time could be attributed to changes in disease incidence or case fatality rate. Very few studies have provided information regarding survival after stroke. We aimed to determine the case-fatality rate (28 days) among patients with first-ever stroke from a population-based study in Ardabil province, Northwest of Iran.

  Methods: This study was conducted between May 2005 and February 2006, all individuals with an acute stroke who were residents in Ardabil province and hospitalized at Alavi Hospital, were registered prospectively and assessed according to standardized diagnostic criteria. The data were analyzed through SPSS, Chi square and variance analysis.

  Results: A total of 352 patients with first-ever stroke were registered, and 346 (96%) were followed up. 288 (81.8%) ischemic stroke, 16.2% (57) ICH and 2% SAH. By 28 days, 70 patients (20.3%) had died. Hypertension, diabetes and cardiac disease history were reported in 61.6%, 16.8% and 26.1% respectively and 19.8% of patients were smokers. Mean age of survivors was different from patients who died at 28 days after index event (64.2±12.9 VS 69.1±10.9, p=0.03). The proportion surviving 28 days varied from 16.2% among patients with ischemic stroke to 43% among ICH and SAH. For ischemic stroke, Survival rates were similar for men and women, whereas men with ICH had lower survival than women.

  Conclusion: Case fatality rate after first-ever stroke is substantial. Rates of mortality differ according to patients diagnosis, age, sex, and heart disease. These data highlight the importance of long-term secondary prevention.