The Erlanger Stroke Project is an Ongoing Prospective Population-based Stroke Registry in Germany, Including All Hospitalized and Nonhospitalized Patients With Stroke in the City of Erlangen (120.000 Inhabitants). (ESPro)

The Erlangen Stroke Project (ESPro)

Stroke is a disease that primarily affects older adults and, with an estimated 64,000 deaths in 2024, is one of the leading causes of death in Germany. Estimates of its prevalence and the burden of disease within the German population are therefore essential for calculating future healthcare needs and guide health policy planning. When the first stroke units (SU) began to emerge in Germany in 1994, health insurers raised the question of the total number of stroke patients requiring care. Unfortunately, at that time there were no reliable figures available to determine the nationwide need for stroke units. This marked the birth of the Erlangen Stroke Registry (ESPro).

For 32 years (1994-2026), ESPro has been continuously collecting data on the epidemiology, clinical course, and care of stroke and dementia, two of the most common diseases. The ESPro is designed as a regional, population-based registry that includes, as far as possible, all diagnosed strokes-that is, both hospitalized and non-hospitalized patients-regardless of age group or severity of the condition. Patients enrolled in the city of Erlangen undergo close monitoring of their clinical course and are followed up at intervals of 3 and 12 months, and then annually for the rest of their lives. This long-term follow-up enables comprehensive health services research on stroke, a widespread disease. Direct information on the course of the disease, its treatment, and care can be gleaned from registry data and incorporated into preventive medicine, treatment, and care planning.

Study Overview

• Status: Recruiting
• Conditions: Cerebral Infarction; Cerebral Vein Thrombosis; Vascular Dementia (VaD); Intracerebral Haemorrhage (ICH); Cerebral Infarction Due to Thrombosis of Cerebral Arteries; Cerebral Infarction Due to Embolism of Cerebral Arteries; Stroke, Not Specified as Haemorrhage or Infarction; Transient Cerebral Ischaemic Attacks and Related Syndromes; Multi-infarct Dementia

• Study Type: Observational
• Enrollment (Estimated): 17000

Contacts and Locations

• Study Contact: Name: Peter L. Kolominsky-Rabas, Univ.-Prof. Dr. med.; Phone Number: +49 9131 85-35855; Email: peter.kolominsky-rabas@fau.de

Study Locations

• Germany
  • Erlangen, Germany, 91054
    • Recruiting
    • Universitätsklinikum Erlangen
  • Erlangen, Germany, 91054
    • Recruiting
    • Malteser Waldkrankenhaus St. Marien
  • Erlangen, Germany, 91056
    • Recruiting
    • Klinikum am Europakanal

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The Erlangen Stroke Project (ESPro) is a community-based survey of all cases of stroke occurring in a university town, located in Bavaria in Southeast Germany. Several overlapping sources of information were used to ensure complete case ascertainment: (1) hospital admission and discharge lists and computer-linked records systems; (2) regular checks of all relevant hospital wards and residential and nursing homes; (3) records of ambulance and emergency services; (4) GPs; and (5) death certificates.

Description

Inclusion Criteria:

• All cases of stroke defined according to WHO criteria, as "rapidly developing clinical symptoms and/or signs of focal, and at times global, loss of cerebral function, with symptoms lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin occurring in Erlangen, Bavaria
• No restrictions regarding age (provided they are of legal age), socioeconomic circumstance, stroke severity, or prior health status

Exclusion Criteria:

• Patients with transient episodes lasting less than 24 hours and those with asymptomatic lesions detected by brain imaging ("silent infarcts")

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
People with stroke; All individuals diagnosed with stroke (both hospitalized and non-hospitalized)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gender		Baseline
Education		Baseline
Postal code		Baseline
Name		Baseline
Address		Baseline
Telephone number		Baseline
Date of birth	as date	Baseline
Date of death	as date	After 3 months, after 12 months, then annually until the event occurs. Currently there is a follow-up of 32 years-up
Nationality		Baseline
Employment status		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Marital status		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Number of children		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Name of the health insurance company		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Length of residence in the study area		Baseline
Living arrangements	Which kind of living arrangement (own home environment, assisted living, nursing home) and who are the people, who live in this arrangement (alone, spouse, children, relatives, others)	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Telephone number of the General practitioner		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Assistance	yes/ no	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Name of the contact person		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Telephone number of the contact person		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Relationship between the patient and the contact person		Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
National Institutes of Health Stroke Scale (NIHSS)	Total Score Range: 0-42 (15 items, each scored on 3-5 point ordinal grades, 0 = normal), higher values indicate greater stroke severity (0 = no stroke symptoms, 1-4 minor, 5-15 moderate, 16-20 moderate-to-severe, 21-42 severe)	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
(Modified) Rankin Scale	Total Score Range: 0-6 (7-point ordinal disability scale), higher values indicate worse (higher) disability (0 = no symptoms, 1 = no significant disability, 2 = slight disability, 3 = moderate disability, 4 = moderately severe disability, 5 = severe disability, 6 = death)	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Mini-Mental State Examination (MMSE)	Total Score Range: 0-30, higher values indicate better cognitive performance	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Medication	Name of the drug	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Medication	Quantity	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Medication	Dose in milligrams per day	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Charlson Comorbidity Index (CCI)	Total Score Range: 0-33, higher values indicate a worse (greater) comorbid disease burden	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Hypertension	yes/ no	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Diabetes mellitus	yes/ no	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Hypercholesterinemia	yes/ no	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
TOAST-Classification	Categorical etiologic classification system; it sorts ischemic stroke into 5 mutually exclusive subtype categories: (1) large-artery atherosclerosis, (2) cardioembolism, (3) small-vessel occlusion (lacunar), (4) stroke of other determined etiology, and (5) stroke of undetermined etiology	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Medical Outcomes Study Social Support Survey (MOS-SSS)	Total Score Range: Raw sum score: 19-95 (19 items, each rated on the 5-point frequency scale: 1 = none of the time … 5 = all of the time), Transformed index (0-100 scale), higher values indicate better (greater) perceived/available social support	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Short Form 36 Health Survey (SF-36)	Physical health and mental health summary scores, Total Score Range: 0-100, norm-based scoring, higher values indicate a better physical/mental health status	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Barthel Index	Total Score Range: 0-100, higher values indicate better functional independence (less disability)	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Frenchay Activities Index (FAI)	Total Score Range: 15-60, higher values indicate better (greater) frequency/independence in instrumental activities of daily living (IADL)	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years
Functional Independence Measure (FIM)	Total Score Range: 18-126, Subscales: FIM-motor 13-91, FIM-cognitive 5-35, higher values indicate better (greater) functional independence (18 = total dependence, 126 = total independence)	Baseline, after 3 months, after 12 months, then annually until the end of the study. Currently there is a follow-up of 32 years

Collaborators and Investigators

• Sponsor: University of Erlangen-Nürnberg Medical School

Publications and helpful links

Helpful Links

• Official project website

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 1994
• Primary Completion (Estimated): March 30, 2094
• Study Completion (Estimated): March 30, 2094

Study Registration Dates

• First Submitted: July 8, 2026
• First Submitted That Met QC Criteria: August 13, 2026
• First Posted (Actual): August 18, 2026

Study Record Updates

• Last Update Posted (Actual): August 18, 2026
• Last Update Submitted That Met QC Criteria: August 13, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Stroke; Registry; Germany; Erlangen
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Mental Disorders; Pathologic Processes; Neurocognitive Disorders; Hemorrhage; Brain Infarction; Brain Ischemia; Infarction; Necrosis; Dementia; Embolism and Thrombosis; Arteriosclerosis; Arterial Occlusive Diseases; Ischemia; Leukoencephalopathies; Intracranial Arteriosclerosis; Intracranial Arterial Diseases; Intracranial Hemorrhages; Intracranial Embolism and Thrombosis; Thromboembolism; Pathological Conditions, Signs and Symptoms; Stroke; Cerebral Infarction; Dementia, Vascular; Cerebral Hemorrhage; Dementia, Multi-Infarct; Intracranial Thrombosis
• Other Study ID Numbers: 249_15 Bc; ZMV I 1-2520KEU305 (Other Grant/Funding Number: German Federal Ministry of Health); DRKS00040516 (Registry Identifier: German Clinical Trials Register)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Information on the use of research data from the Erlangen Stroke Registry can be found on the website at the following link: https://www.izph.fau.de/projekte/erlanger-schlaganfallregister/#angebot-zur-nutzung-von-forschungsdaten-aus-dem-erlanger-schlaganfallregister

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No