Incidence, short-term outcome, and spatial distribution of stroke patients in Ludhiana, India

Pandian, Jeyaraj Durai; Singh, Gagandeep; Kaur, Prameet; Rajinder, Bansal; Paul, Birinder S; Singla, Monika; Singh, Shilpa; Samuel, Clarence; Verma, Shweta Jain; Moodbidri, Premjeeth; Mehmi, Gagandeep; Sharma, Amber; Arora, O.P.; Dhanuka, A K; Sobti, Manoj K; Sehgal, Harish; Kaur, Manpreet; Grewal, Sarvpreet Singh; Jhawar, Sanjay; Shadangi, T N; Arora, Tushar; Saxena, Ashish; Sachdeva, Gaurav; Gill, Jeetamol S; Brar, Ramandeep; Gill, Anakhvir; Bakshi, Sandeep S; Pawar, Sandeep S; Singh, Gurmeet; Sikka, Praveen; Litoria, P. K.; Sharma, Meenakshi

doi:10.1212/wnl.0000000000002335

Cited by 33 publications

(53 citation statements)

References 25 publications

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“…This indicates that stroke mortality is potentially much higher in Gadchiroli compared with these other contexts. Our results are broadly consistent with a number of studies documenting a high incidence and mortality rate from stroke in specific Indian subpopulations 8–11 21–24. Similarly, the high burden of stroke in Gadchiroli is consistent with recent nationally representative evidence that finds high levels of stroke mortality in eastern states, such as Chhattisgarh, that are geographically adjacent to Gadchiroli, and have similar levels of development and healthcare services 9.…”

Section: Discussionsupporting

confidence: 91%

Direct estimates of disability-adjusted life years lost due to stroke : a cross-sectional observational study in a demographic surveillance site in rural Gadchiroli, India

2019

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ObjectiveTo directly estimate disability-adjusted life years (DALYs) lost due to stroke in rural Gadchiroli, India and measure the contribution of mortality and disability to total DALYs lost.DesignCross-sectional descriptive study using population census, vital registration and stroke prevalence data.SettingA demographic surveillance site of 86 villages in Gadchiroli, a rural district in Maharashtra, India.ParticipantsPopulation counts and mortality information were drawn from a census and vital registration system covering a population of approximately 94 154 individuals; stroke prevalence information was based on a door-to-door evaluation of all 45 053 individuals from 39 of the 86 villages in the surveillance site.Primary outcome measuresYears of life lost (YLL), years lived with disability (YLD) and DALYs lost due to stroke.ResultsThere were 229 stroke deaths among the total population of 94 154 individuals and 175 stroke survivors among the subpopulation of 45 053 individuals. An estimated 2984 DALYs were lost due to stroke per 100 000 person-years with a higher burden among men compared with women (3142 vs 2821 DALYs). Over three-fourths (80%) of the total DALYs lost due to stroke were between ages 30 and 70 years. YLL accounted for 98.9% of total DALYs lost.ConclusionsThere was a high burden of stroke in rural Gadchiroli with a significant burden at premature ages. These results reveal a substantial need for surveillance and improved preventive and curative services for stroke in rural India.

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Section: Discussionsupporting

confidence: 91%

Direct estimates of disability-adjusted life years lost due to stroke : a cross-sectional observational study in a demographic surveillance site in rural Gadchiroli, India

2019

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“…This is due to a proportionate increase in the total number of stroke patients who came within the window period. This can be partly explained by the establishment of “Ludhiana population-based stroke registry,”[ 12 ] which was an epidemiologic project carried out from 2010 till 2013 by the department of neurology. As part of the registry several public awareness, campaigns and educational sessions for general practitioners and physicians were held in the city.…”

Section: Discussionmentioning

confidence: 99%

Quality indicators of intravenous thrombolysis from North India

William¹,

Pannu²,

Kate³

et al. 2017

Ann Indian Acad Neurol

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Background:Data on intravenous (IV) thrombolysis using tissue plasminogen activator (tPA) are limited from low- and middle-income countries. We aimed to assess the quality indicators of IV thrombolysis in our stroke unit.Methods:All stroke patients admitted in our hospital from October 2008 to April 2017 were included in this study. Data were collected prospectively by trained research staff in a detailed case record form. Outcome was assessed using modified Rankin Scale (mRS, 0–1 good outcome).Results:Of the total 4720 stroke patients seen, 944 (20%) came within window period (<4.5 h). Of these, 214 (4.5%) were eligible for thrombolysis and 170 (3.6%) were thrombolysed, relatives of 23 (23/214, 10.7%) patients denied consent, and 21 (9.8%) patients could not afford tPA. The mean age of thrombolysed patients was 58.4 (range 19–95) years. Median NIHSS at admission was 12 (interquartile range 2–24). Average onset-to-door (O-D) time was 76.8 (5–219) min, door-to-examination (D-E) time was 17.8 (5–105) min, door-to-CT (D-CT) time was 48 (1–205) min, and door-to-needle (D-N) time was 90 (20–285) min. At 6 months, 110 (64.7%) patients were contactable and 82 (74.5%) patients had good outcome (mRS 0–1).Conclusion:Thrombolysis rate has steadily increased at the center without undue adverse effects even in the elderly. D-E and D-CT times have reduced, but O-D and D-N times need further improvement. More patients could be thrombolysed if the cost of tPA is reduced and the consent process is waived.

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“…Untreated atrial fibrillation can increase the risk of stroke, and in the context of India, where rapid stroke management is suboptimal, prevention of stroke through early diagnosis of atrial fibrillation becomes crucial 29 . The technology developed by the UMMS atrial fibrillation research group in collaboration with local biomedical engineers uses a mobile phone to screen for atrial fibrillation 30 .…”

Section: Trainee-led Twinning Model For Global Healthmentioning

confidence: 99%

RAHI–SATHI Indo-U.S. Collaboration: The Evolution of a Trainee-Led Twinning Model in Global Health Into a Multidisciplinary Collaborative Program

Soni

Fahey

Jaffe

et al. 2017

Glob Health Sci Pract

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RAHI–SATHI presents an innovative twinning model of global health academic partnership, resulting in a number of successful research activities, that features trainees or students as the driving force, complemented by strategic institutional support from both sides of the partnership. Others can promote similar student-led initiatives by: (1) accepting an expanded role for trainees in global health programs, (2) creating structured research and program opportunities for trainees, (3) developing a network of faculty and trainees interested in global health, (4) sharing extramural global health funding opportunities with faculty and trainees, and (5) offering seed funding.

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Incidence, short-term outcome, and spatial distribution of stroke patients in Ludhiana, India

Abstract: The incidence rates are similar to other studies from India. Stroke patient survival is poor in public hospitals. The finding of spatial analysis is of public health significance for stroke prevention and strengthening of stroke services.

Cited by 33 publications

References 25 publications

Direct estimates of disability-adjusted life years lost due to stroke : a cross-sectional observational study in a demographic surveillance site in rural Gadchiroli, India

Direct estimates of disability-adjusted life years lost due to stroke : a cross-sectional observational study in a demographic surveillance site in rural Gadchiroli, India

Quality indicators of intravenous thrombolysis from North India

RAHI–SATHI Indo-U.S. Collaboration: The Evolution of a Trainee-Led Twinning Model in Global Health Into a Multidisciplinary Collaborative Program

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