Cerebrovascular disease at autopsy and in the death statistics for the county of Hordaland, Norway

Between 1975 and 1984 a decrease in deaths from cerebrovascular disorders was found both at autopsy and in the official mortality statistics. In the autopsy material (662 cases) the decrease was seen mainly in patients dying of cerebral hemorrhage. Concordance between autopsy and mortality statistics was best in the 30 to 79-year age group. Discordance rose with age, being highest in those above 80 years. This was mainly due to use of the diagnosis "undetermined vascular lesion" given as the clinical cause of death. The diagnosis was not upheld at autopsy. In such cases the presence of a cerebral lesion was rarely confirmed at autopsy. The decrease in acute cerebrovascular deaths was not accompanied by an increase in the number of patients in the category "stroke with sequelae", assessed as a fall in number. Thus mortality statistics can be directly misleading in geriatric patients; and the autopsy frequency in this age group is too low to give a satisfactory picture of events.