Epidemiología de la enfermedad vascular cerebral en España

Brea, Ángel; Laclaustra, Martín; Martorell, Esperanza; Pedragosa, Àngels

doi:10.1016/j.arteri.2013.10.006

Cited by 35 publications

(21 citation statements)

References 20 publications

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“…In Spain, CVA are the second leading cause of mortality in general population, and the first in women [ 9 ], specially affecting the elderly [ 10 ]. Stroke incidence has been evaluated in several studies in our country with a great variability between them [ 11 ] and most of studies included both, ischemic and hemorrhagic subtypes. Incidence rates fluctuate between 120 and 350 cases per 100.000 people/year [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012)

et al. 2015

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BackgroundType 2 Diabetes (T2DM) is the most rapidly increasing risk factor for ischemic stroke. We aimed to compare trends in outcomes for ischemic stroke in people with or without diabetes in Spain between 2003 and 2012.MethodsWe selected all patients hospitalized for ischemic stroke using national hospital discharge data. We evaluated annual incident rates stratified by T2DM status. We analyzed trends in the use of diagnostic and therapeutic procedures, patient comorbidities, and in-hospital outcomes. We calculated in-hospital mortality (IHM), length of hospital stay (LOHS) and readmission rate in one month after discharge. Time trend on the incidence of hospitalization was estimated fitting Poisson regression models by sex and diabetes variables. In-hospital mortality was analyzed using logistic regression models separate for men and women. LOHS were compared with ANOVA or Kruskal-Wallis when necessary.ResultsWe identified a total of 423,475 discharges of patients (221,418 men and 202,057 women) admitted with ischemic stroke as primary diagnosis. Patients with T2DM accounted for 30.9% of total. The estimated incidence rates of discharges increased significantly in all groups. The incidence of hospitalization due to stroke (with ICD9 codes for stroke as main diagnosis at discharge) was higher among those with than those without diabetes in all the years studied. T2DM was positively associated with ischemic stroke with an adjusted incidence rate ratio (IRR) of 2.27 (95% CI 2.24–2.29) for men and 2.15 (95%CI 2.13–2.17) for women. Over the 10 year period LOHS decreased significantly in men and women with and without diabetes. Readmission rate remained stable in diabetic and non diabetic men (around 5%) while slightly increased in women with and without diabetes. We observed a significant increase in the use of fibrinolysis from 2002–2013. IHM was positively associated with older age in all groups, with Charlson Comorbidity Index > 3 and atrial fibrillation as risk factors. The IHM did not change significantly over time among T2DM men and women ranging from 9.25% to 10.56% and from 13.21% to 14.86%, respectively; neither did among non-diabetic women. However, in men without T2DM IHM decreased significantly over time. Diabetes was associated to higher IHM only in women (OR 1.07; 95% CI, 1.05–1.11).ConclusionsOur national data show that incidence rate of ischemic stroke hospitalization increased significantly during the period of study (2003–2012). People with T2DM have more than double the risk of ischemic stroke after adjusting for other risk factors. Women with T2DM had poorer outcomes- IHM and readmission rates- than diabetic men. Diabetes was an independent factor for IHM only in women.

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Section: Introductionmentioning

confidence: 99%

Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012)

et al. 2015

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“…This figure has increased during the last years allowing the patients to receive a specific and proactive treatment. However, this study shows that decision-makers need to follow the recommendations from the Spanish Stroke Plan to benefit all the population and clearly promoting extension of the model to the majority of the more than 100,000 strokes that occur annually in Spain [ 45 ]. Expanding the coverage can be achieved by increasing the number of stroke units or through the use of telemedicine systems which allow the new techniques to be implemented even in rural areas where the population has poor access to tertiary hospitals such as those included in this study [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes measured by mortality rates, quality of life and degree of autonomy in the first year in stroke units in Spain

Mar

Masjuán

Oliva‐Moreno

et al. 2015

Health Qual Life Outcomes

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IntroductionThe primary objective of this sub analysis of the CONOCES study was to analyse outcomes in terms of mortality rates, quality of life and degree of autonomy over the first year in patients admitted to stroke units in Spain. The secondary objective was to identify the factors determining good prognosis.MethodsWe studied a sample of patients who had suffered a confirmed stroke and been admitted to a Stroke Unit in the Spanish healthcare system. Socio-demographic and clinical variables and variables related to the level of severity (NIHSS), the level of autonomy (Barthel, modified Rankin) and quality of life (EQ-5D) were recorded at the time of admission and then three months and one year after the event. Factors determining prognosis were analysed using logistic regression and ROC curves.ResultsA total of 321 patients were recruited, 33% of whom received thrombolytic treatment, which was associated with better results on the Barthel and the modified Rankin scales and in terms of the risk of death. Mean quality of life measured through EQ-5D improved from 0.57 at discharge to 0.65 one year later. Full autonomy level measured by Barthel index increased from 30.1% at discharge to 52.8% at one year and by the modified Rankin scale from 51% to 71%. The rates for in-hospital and 1-year mortality were 5.9% and 17.4% respectively. Low NIHSS scores were associated with a good prognosis with all the outcome variables. The three instruments applied (NIHSS, Barthel and modified Rankin scales) on admission showed good discriminative ability for patient prognosis in the ROC curves.ConclusionsThere has been a change in the prognosis for stroke in Spain in recent years as the quality of life at 1 year observed in our study is clearly higher than that obtained in other Spanish studies conducted previously. Moreover, survival and functional outcome have also improved following the introduction of a new model of care. These results clearly promote extension of the model based on stroke units and reinforced rehabilitation to the majority of the more than 100,000 strokes that occur annually in Spain.

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“…e global burden of stroke has continued to increase, representing an important public health problem and the second cause of death worldwide [2][3][4]. However, mortality after a stroke has decreased in recent years probably due to an improved control of risk factors, the recognition of stroke signs, an improvement in hospital care during the acute phase, and the development of strategies for secondary prevention, together with complementary interventions that offer comprehensive patient treatment [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

Cano-Manas

Collado-Vázquez

Hernández

et al. 2020

Journal of Healthcare Engineering

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Purpose. To determine the effects of a structured protocol using commercial video games on balance, postural control, functionality, quality of life, and level of motivation in patients with subacute stroke. Methods. A randomized controlled trial was conducted. A control group (n = 25) received eight weeks of conventional rehabilitation consisting of five weekly sessions based on an approach for task-oriented motor training. The experimental group (n = 23) received conventional rehabilitation + video-game based therapy for eight weeks with commercial video games using the Xbox 360° video games console and the Kinect® device with the same total treatment time for both groups. The Modified Rankin Scale, Barthel Index, Tinetti scale, Functional Reach test, Get Up and Go test, Baropodometry, EuroQoL 5D (EQ-5D), satisfaction, adherence, and motivation were used as outcome measures. Results. In the between-group comparison, statistically significant differences were observed in the Modified Rankin scores (p<0.01), the Barthel Index (p=0.05), the Tinetti gait assessment (p=0.02), the Functional Reach test (p<0.01), the Get Up and Go test (p=0.05), the pain/discomfort dimension (p<0.01), and anxiety/depression dimension (p<0.01) of the EQ-5D and the VAS (visual analog scale) (p<0.01) on the perceived health status based on the EQ-5D questionnaire. Regarding the scale of motivation, self-esteem, and adherence, statistically significant differences were achieved in motivation (p<0.01), self-esteem (p<0.01), and adherence (p<0.01) variables. Conclusion. A protocol of semi-immersive video-game based therapy, combined with conventional therapy, may be effective for improving balance, functionality, quality of life, and motivation in patients with subacute stroke. This trial is registered with NCT03528395.

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Epidemiología de la enfermedad vascular cerebral en España

Cited by 35 publications

References 20 publications

Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012)

Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012)

Outcomes measured by mortality rates, quality of life and degree of autonomy in the first year in stroke units in Spain

Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

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