The Stroke Data Bank: design, methods, and baseline characteristics.

Abstract

and Stroke initiated the Stroke Data Bank, which is a multicenter project to prospectively collect data on the clinical course and sequelae of stroke. Additional objectives were to provide information that would enable a standard diagnostic clinical evaluation, to identify prognostic factors, and to provide planning data for future studies. A brief description of the structure and methods precede the baseline characterization of 1,805 patients enrolled in the Stroke Data Bank between July 1983 and June 1986. Two thirds of these patients were admitted within 24 hours after stroke onset. Medical history, neurologic history, and hospitalization summaries are presented separately for the following stroke subtypes: infarction, unknown cause; embolism from cardiac source; infarction due to atherosclerosis; lacune; parenchymatous or intracerebral hemorrhage; subarachnoid hemorrhage; and other. The utility and limitations of these data are discussed. (Stroke 1988;19:547-554) S troke is the third leading cause of death in the United States; only coronary heart disease and cancer are more prevalent causes of death. In 1985, there were 153,050 deaths attributed to cerebrovascular diseases and a crude death rate of 64.1 per 100,000 resident population.1 Cerebrovascular diseases are also a major cause of chronic disability, affecting millions of Americans. In 1978, the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) initiated a data bank project to provide prospectively and consistently recorded information on stroke to address some of the many unresolved research issues in cerebrovascular disease. The Stroke Data Bank (SDB) had four major objec- Received August 10, 1987; accepted November 17, 1987. tives: 1) to obtain information on the clinical course and outcome of stroke, 2) to provide information that would enable a standard diagnostic clinical evaluation, 3) to identify factors predictive of outcome following stroke, and 4) to provide planning data for future controlled, randomized, clinical trials in the treatment of stroke patients. The purpose of our report is to provide a comprehensive description of the project background, design, and methods and a description of the patients enrolled. Additional details (including copies of the data collection forms) are available in the SDB Manual of Operations.2 Previous communications have reported on the pilot phase, 3 reliability studies, 4 -5 and nursing implications 6 of this project. The primary analytic publications from the main phase of the SDB are now in preparation. Design and Methods Project OrganizationCooperative clinical projects require an organizational structure that will both facilitate efficient operation and at the same time provide a mechanism to ensure participation of all collaborators in the decisionmaking process. Toward these goals, the organizational structure developed for the SDB fostered careful and uniform adherence to the procedures for data collection and effective communication and cooperation among the va...

Clinical study of acute stroke with special reference to Greek stroke scoring system

“…History of previous stroke was present in 10% in Mahajan et al18 and 16.6% in Kora SA et al 26 Actually TIA is a major risk factor for disabling stroke, implying a 13-fold increased risk of stroke in the next one year. 27 In the present study, dyslipidemia was the most common risk factor in cerebral ischemia patients seen in 80.5% of ischemic stroke patients followed by hypertension seen in 64%. On the other side in hemorrhagic stroke patients, hypertension was the commonest risk factor seen in 78.5% of patients with intracerebral hemorrhage followed by history of chronic alcohol intake which was seen in 64.2%.…”

“…Similar result was also seen in another study by EL Tallawy HN et al 19 Convulsions in the present series were present only in 4% of the total patients, which is comparable to that of Mohr et al and Foulkes et al, who reported frequency of 7% and 9% respectively. 27,28 On clinical examination right hemiparesis was seen in 23 cases (46%), left hemiparesis in 19 cases (38%), facial nerve palsy was seen in 44%, aphasia and dysarthria in 22% and 16% respectively, monoparesis in 4% and cranial nerve 9,10 were involved in one patient (2%).…”

Treatment of Cognitive Impairment After Poststroke Depression

“…20 All neurological evaluations and CT scan readings were performed with the investigator blind to the findings on the psychopathological examination. Lesion volume was calculated from the ratio of the largest cross-sectional area of the lesion to the crosssectional area of the brain at the level of the body of the lateral ventricle.…”

Standardizing Data Collection in Traumatic Brain Injury

“…Pooling data from multiple studies (individual patient data analysis), and comparative effectiveness research (CER) utilizing prospective observational data collection, can provide alternative sources of evidence that can be obtained in a more costefficient way. The direct relevance and potential of such approaches is illustrated by the results from the meta-analysis of individual patient data performed by the IMPACT study group, and by the fact that major advances in clinical care for TBI have resulted from previous observational studies, such as the U.S. Traumatic Coma Databank (Foulkes et al, 1991), the European Brain Injury Consortium (EBIC) Core Data Survey (Murray et al, 1999), The Vietnam Head Injury Study (Salazar et al, 1995), and the Trauma Audit And Research Network Registry (TARN; Patel et al, 2005). When undertaking high-quality observational data collection across multiple settings, or when analyzing individual patient data from various studies, standardization of data collection and coding is essential.…”