The Besangon Stroke Registry: An Acute Stroke Registry of 2,500 Consecutive Patients

Abstract

The purpose of this study was to estimate the frequency of various risk factors, courses and outcome of stroke subtypes in a large hospital-based stroke registry. The Centre Hospitalier Universitaire of Besançon is the only public hospital with a neurological department in the county to admit any unselected patient with an acute stroke. A prospective hospital-based registry using systematic computer coding of data was conducted. All patients were evaluated by standard testing (neuroimaging, Doppler ultrasonography and cardiac investigations). From 1987 to 1994, 2,500 stroke patients with a first-ever stroke were included in the Besançon Stroke Registry. There were 1,425 men (mean age 66.1 years) and 1,075 women (mean age 70.6 years). Ischemic stroke was present in 84% of the patients (cerebral infarction in 84.5% and transient ischemic attacks in 15.5%), primary intracerebral hemorrhage (PIH) in 14.2% and cerebral venous thrombosis in 1.8%. On the 1st day of the stroke 79.7% of the patients were admitted, 47.1% within 6 h. In addition, stroke severity was well correlated with the time of the patient''s admission. Past medical history of hypertension was the major risk factor occurring in 55.8% of all patients, followed by smoking, atrial fibrillation, ischemic heart disease, hypercholesterolemia and diabetes mellitus. Clinical presentation was distributed according to classical patterns. The in-hospital mortality rate was 13.6% and was higher in patients with infarcts (13.7%) or PIH (25.6%). Logistic regression analysis determined independent predictive factors for death: deterioration at 48 h [odds ratio (OR) 10.1, 95% confidence interval (CI) 7.0-14.5], initial loss of consciousness (OR 4.5, 95% CI 3.1-6.4), age <70 (OR 2.6, 95% CI 1.8-3.8), complete motor deficit (OR 1.9, 95% CI 1.3-2.8), major cognitive syndrome (OR 1.5, 95% CI 1.1-2.3), hyperglycemia at admission (OR 1.007, 95% CI 1.004-1.01), female gender (OR 0.7, 95% CI 0.5-0.9) and regressive stroke onset (OR 0.2, 95% CI 0.1-0.5). The Besançon Stroke Registry is a useful tool for the study of the risk factors, clinical features, and the course of strokes in an early phase.

Stroke Epidemiology in Douala: Three Years Prospective Study in a Teaching Hospital in Cameroon

“…On the other hand, the low rate of diabetes in Senegalese may be due to their Sahelien style of life and the possible existence of environmental factors which may influence the risk of diabetes cannot be totally excluded. The prevalence rate of diabetes in stroke patients is similar to ours in Europe [15] but lower than 45% reported in Saudi Arabia [14]. We found regular consumption of alcohol to be an important vascular risk factor in this study, present in 28.30% of cases.…”

“…Sagui et al in Dakar, Senegal found a mean age of 61.9 ± 12.4 in 2008 in Dakar [12], a result similar to that of other developing countries [13] [14]. The mean age in the current study is 8 to 15 years lower than that observed in developed countries [15] [16]. Situation is same with life expectancy between developing and developed countries.…”

“…The prevalence hypertension in stroke victims appears to be lower in developed countries [15] [16] and is situated around 55%. The review of Sagui [19] on stroke in sub Saharan Africa estimated the prevalence of hypertension between 32.3% and 68% among stroke victims.…”

“…Before stroke, 8.9% of the patients were known for dyslipidaemia and in the course of stroke, this prevalence rose to 13 [18]. In developed countries, the prevalence of atrial fibrillation in the course of constituted ischaemic stroke is estimated between 15% and 20% [15] [16].…”

Predictors of In-Hospital Mortality after Acute Ischemic Stroke in Subjects with and without Diabetes Mellitus

“…Many studies have shown higher mean admission glucose level in nonsurvivors of stroke compared with survivors [32][33][34]. Furthermore, two large studies demonstrated that glucose level at hospital admission was a significant predictor of mortality [35] or poor functional recovery [36] after stroke independent of other prognostic factors. In addition, a study showed that persistent hyperglycemia was an independent determinant of infarct expansion and was associated with worse functional outcome [37].…”