Stroke Incidence and Case Fatality Rate in an Urban Population

Okon, Marvin; Adebobola, Nathaniel I.; Julius, Soyinka; Adebimpe, Obembe; Taiwo, Akinwole O.; Akinyemi, Akanni Ibukun; Thomas, Nathaniel I.

doi:10.1016/j.jstrokecerebrovasdis.2014.11.004

Cited by 26 publications

(25 citation statements)

References 27 publications

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“…We found that hypertensive stroke patients with age > 80 years are more likely to be excluded more from rtPA in the non telestroke setting. Observational studies aimed at monitoring the safety of rtPA provided comparative results on stroke outcome between patients > 80 years and those < 80 years [63, 69–72]. Findings reveal that > 80 years are less likely to achieve good outcomes compared with < 80 years.…”

Section: Discussionmentioning

confidence: 99%

Predictors of thrombolysis in the telestroke and non telestroke settings for hypertensive acute ischemic stroke patients

et al. 2018

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BackgroundIn acute ischemic stroke patients, telestroke technology provides sustainable approaches to improve the use of thrombolysis therapy. How this is achieved as it relates to inclusion or exclusion of clinical risk factors for thrombolysis is not fully understood. We investigated this in a population of hypertensive stroke patients.MethodsStructured data from a regional stroke registry that contained telestroke and non telestroke patients with a primary diagnosis of acute ischemic stroke with history of hypertension were collected between January 2014 and June 2016. Clinical risk factors associated with inclusion or exclusion for recombinant tissue plasminogen activator (rtPA) in the telestroke and non telestroke were identified using multiple regression analysis. Associations between variables and rtPA in the regression models were determined using variance inflation factors while the fitness of each model was determined using the ROC curve to predict the power of each logistic regression model.ResultsThe non telestroke admitted more patients (62% vs 38%), when compared with the telestroke. Although the telestroke admitted fewer patients, it excluded 11% and administered thrombolysis therapy to 89% of stroke patients with hypertension. In the non telestroke group, adjusted odd ratios showed significant associations of NIH stroke scale score (OR = 1.059, 95% CI, 1.025–1.093, P < 0.001) and coronary artery disease (OR = 2.003, 95% CI, 1.16–3.457, P = 0.013) with inclusion, while increasing age (OR = 0.979, 95% CI, 0.961–0.996, P = 0.017), higher INR (OR = 0.146, 95% CI, 0.032–0.665, P = 0.013), history of previous stroke (OR = 0.39, 95% CI, 0.223–0.68, P = 0.001), and renal insufficiency (OR = 0.153, 95% CI, 0.046–0.508, P = 0.002) were associated with rtPA exclusion. In the telestroke, only direct admission to the telestroke was associated with rtPA administration, (OR = 4.083, 95% CI, 1.322–12.611, P = 0.014).ConclusionThe direct admission of hypertensive stroke patients to the telestroke network was the only factor associated with inclusion for thrombolysis therapy even after adjustment for baseline variables. The telestroke technology provides less restrictive criteria for clinical risk factors associated with the inclusion of hypertensive stroke patients for thrombolysis.

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Section: Discussionmentioning

confidence: 99%

Predictors of thrombolysis in the telestroke and non telestroke settings for hypertensive acute ischemic stroke patients

et al. 2018

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“…The age-standardised incidence rate was 155 per 100 000 in men and 158 per 100 000 in women in the control communities. Other study reported that adjusted age-standardised incidence rate was 60.67 per 100 000 per year after adjustment to the WHO world population 22. Incidence of cerebral infarction and intracerebral haemorrhage increased with age in both men and women 22…”

Section: Discussionmentioning

confidence: 97%

Community-based stroke system of care improves patient outcomes in Chinese rural areas

Wang

Dong

et al. 2018

J Epidemiol Community Health

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“…The scores ranged from 0 to 3 in this fashion: undocumented (0), patients not able to ambulate (1), able to ambulate with assistance (2), and able to ambulate independently (3). The validity of the scoring has been described in previous studies [42][43][44][45]. Each patients' ambulatory status was tracked and collected on admission, during admission, and after discharge.…”

Section: Study Populationmentioning

confidence: 99%

Cholesterol reducer and thrombolytic therapy in acute ischemic stroke patients

et al. 2020

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Background: Specific clinical risk factors may contribute to improving or worsening neurological functions in acute ischemic stroke (AIS) patients pre-treated with a combined cholesterol reducer and recombinant tissue plasminogen activator (rtPA) therapy. In this study, clinical risk factors associated with good or poor presenting neurological symptoms in ischemic stroke patients with prior cholesterol reducer use, specifically a statin and rtPA therapy was investigated. Methods: Retrospective data for baseline clinical and demographic data for patients with AIS taking cholesterol reducers prior to rtPA treatment from January 2010 to June 2016 in a regional stroke center was analyzed. Improving (NIHSS score ≤ 7) or worsening (NIHSS score > 7) of neurologic functions were the determined measures of treatment outcome. Multivariate logistic regression models identified demographic and clinical factors associated with worsening or improving neurologic functions. Results: Adjusted multivariate analysis showed that in an AIS population with a combined rtPA and cholesterol reducer medication history, increasing age (OR = 1.032, 95% CI, 1.015-1.048, P < 0.001) and atrial fibrillation (OR = 1.859, 95% CI, 1.098-3.149, P = 0.021) demonstrated a likely association with worsening neurologic functions, while direct admission (OR = 0.411, 95% CI, 0.246-0.686, P = 0.001) and being Caucasian (OR = 0.496, 95% CI, 0.297-0.827, P = 0.007) showed an association with improving or progressing neurologic functions. Conclusion: A prior cholesterol reducer, namely a statin, plus rtPA combination may be associated with worsening neurological function for elderly AIS patients with atrial fibrillation, while Caucasians directly admitted to a neurology unit are more likely to show an association with progress or improvements in neurologic functions. While combining statin with rtPA treatment may facilitate worsening neurologic functions in elderly AIS patients with atrial fibrillation, they should not be denied of this therapy. The decision to combine statin and rtPA for AIS patients with atrial fibrillation can be done after clinical stabilization following appropriate clinical management.

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Stroke Incidence and Case Fatality Rate in an Urban Population

Cited by 26 publications

References 27 publications

Predictors of thrombolysis in the telestroke and non telestroke settings for hypertensive acute ischemic stroke patients

Predictors of thrombolysis in the telestroke and non telestroke settings for hypertensive acute ischemic stroke patients

Community-based stroke system of care improves patient outcomes in Chinese rural areas

Cholesterol reducer and thrombolytic therapy in acute ischemic stroke patients

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