Trends in Risk Factors, Stroke Subtypes and Outcome

Background: Prospective stroke registries allow analyzing important aspects of the natural history of acute cerebrovascular events. Using the Sagrat Cor Hospital of Barcelona Stroke Registry, we aimed to determine trends in risk factors, stroke subtypes, prognosis and in-hospital mortality over 19 years in hospitalized stroke patients. Methods: The study population consisted of 2,416 first-ever stroke patients (ischemic stroke, n = 2,028; intracerebral hemorrhage, n = 334) included in the stroke registry up to December 31, 2004. Temporal trends in stroke patient characteristics for the periods 1986–1992, 1993–1998 and 1999–2004 were assessed. Results: Age was significantly different among the analyzed periods (p < 0.001), showing an increment in older patients throughout time. Hypertension (p = 0.001), diabetes (p = 0.004), ischemic heart disease (p = 0.002) and atrial fibrillation increased (p = 0.000) as opposed to heavy smoking (p = 0.000) and history of TIA (p = 0.025). The mortality rate and the length of hospital stay decreased (p = 0.001), whereas transfer to convalescent/rehabilitation units increased (p = 0.001). Conclusions: An improvement in acute-stroke management and possibly evolution of cerebrovascular risk factors is reflected by changes in the risk factors and outcome of first-ever stroke patients admitted to a stroke unit over a 19-year time span.

[1]  A. Arboix.  Increasing relevance of acute cerebrovascular disease in very old patients , 2007, European journal of neurology.

[2]  A. Arboix,et al.  Recurrent lacunar infarction following a previous lacunar stroke: a clinical study of 122 patients , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[3]  M. A. Moro,et al.  The metabolic syndrome and stroke: potential treatment approaches. , 2007, Stroke.

[4]  M. Maeder-Ingvar,et al.  Trends in Risk Factors, Patterns and Causes in Hospitalized Strokes over 25 Years: The Lausanne Stroke Registry , 2007, Cerebrovascular Diseases.

[5]  Z. Izadi,et al.  The Khorasan Stroke Registry: Results of a Five-Year Hospital-Based Study , 2006, Cerebrovascular Diseases.

[6]  A. Arboix,et al.  Cardiovascular risk factors in patients aged 85 or older with ischemic stroke , 2006, Clinical Neurology and Neurosurgery.

[7]  A. Arboix,et al.  Impact of Female Gender on Prognosis in Type 2 Diabetic Patients with Ischemic Stroke , 2006, European Neurology.

[8]  Gelin Xu,et al.  Subtypes and One-Year Survival of First-Ever Stroke in Chinese Patients: The Nanjing Stroke Registry , 2006, Cerebrovascular Diseases.

[9]  Hong-Ki Song,et al.  The Hallym Stroke Registry: A Web-Based Stroke Data Bank with an Analysis of 1,654 Consecutive Patients with Acute Stroke , 2005, European Neurology.

[10]  J. Forbes,et al.  Community-Based Stroke Incidence in a Scottish Population: The Scottish Borders Stroke Study , 2005, Stroke.

[11]  Joseph P Broderick,et al.  Acute Stroke Care in the US: Results from 4 Pilot Prototypes of the Paul Coverdell National Acute Stroke Registry , 2005, Stroke.

[12]  O. Benavente,et al.  Small vessel strokes , 2005, Current cardiology reports.

[13]  L. Pazdera,et al.  New England medical center posterior circulation registry , 2004, Annals of neurology.

[14]  J. Ferro,et al.  Prospective Community-Based Study of Stroke in Northern Portugal: Incidence and Case Fatality in Rural and Urban Populations , 2004, Stroke.

[15]  A. Laupacis,et al.  Stroke Care Delivery in Institutions Participating in the Registry of the Canadian Stroke Network , 2004, Stroke.

[16]  C. Wolfe,et al.  Incidence and Case Fatality Rates of First-Ever Stroke in a Black Caribbean Population: The Barbados Register of Strokes , 2004, Stroke.

[17]  J. Attia,et al.  Seasonal Variation in Stroke in the Hunter Region, Australia: A 5-Year Hospital-Based Study, 1995-2000 , 2003, Stroke.

[18]  J. Reddy,et al.  Subtypes of ischemic stroke in a metropolitan city of South India (one year data from a hospital based stroke registry) , 2002 .

[19]  H. Diener,et al.  Risk Factors, Outcome, and Treatment in Subtypes of Ischemic Stroke: The German Stroke Data Bank , 2001, Stroke.

[20]  A. Arboix,et al.  Acute Cerebrovascular Disease in Women , 2001, European Neurology.

[21]  D. Radak,et al.  [Classification of cerebrovascular diseases]. , 2001, Srpski arhiv za celokupno lekarstvo.

[22]  A. Arboix,et al.  Ischemic stroke of unusual cause: clinical features, etiology and outcome , 2001, European journal of neurology.

[23]  A. Arboix,et al.  Different vascular risk factor profiles in ischemic stroke subtypes: a study fromthe “Sagrat Cor Hospital of Barcelona Stroke Registry” , 2000, Acta neurologica Scandinavica.

[24]  J. McNeil,et al.  Stroke Incidence on the East Coast of Australia: The North East Melbourne Stroke Incidence Study (NEMESIS) , 2000, Stroke.

[25]  J. Lekakis,et al.  The Athens Stroke Registry: Results of a Five-Year Hospital-Based Study , 2000, Cerebrovascular Diseases.

[26]  A. Arboix,et al.  Early differentiation of cardioembolic from atherothrombotic cerebral infarction: a multivariate analysis , 1999, European journal of neurology.

[27]  C. Wolfe,et al.  Ethnic differences in incidence of stroke: prospective study with stroke register , 1999, BMJ.

[28]  J. Martí-Vilalta,et al.  The Barcelona Stroke Registry , 1999, European Neurology.

[29]  D. Grobbee,et al.  Stroke incidence and case fatality in southern Greece: the Arcadia stroke registry. , 1999, Stroke.

[30]  Bruce Neal,et al.  1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. , 1999, Journal of hypertension.

[31]  E. Kumral,et al.  The Ege Stroke Registry: A Hospital-Based Study in the Aegean Region, Izmir, Turkey , 1998, Cerebrovascular Diseases.

[32]  J. Frey,et al.  Differences in stroke between white, Hispanic, and Native American patients: the Barrow Neurological Institute stroke database. , 1998, Stroke.

[33]  J. Jeng,et al.  Subtypes of ischemic stroke. A hospital-based stroke registry in Taiwan (SCAN-IV). , 1997, Stroke.

[34]  J. Whisnant.  Modeling of risk factors for ischemic stroke. The Willis Lecture. , 1997, Stroke.

[35]  P A Wolf,et al.  American Heart Association Prevention Conference IV: prevention and rehabilitation of stroke: executive summary. , 1997, Circulation.

[36]  L. Rumbach,et al.  The Besançon Stroke Registry: an acute stroke registry of 2,500 consecutive patients. , 1997, European neurology.

[37]  N. Bornstein,et al.  The Tel Aviv Stroke Registry. 3600 consecutive patients. , 1996, Stroke.

[38]  A. Arboix,et al.  [An analysis of 1000 consecutive patients with acute cerebrovascular disease. The registry of cerebrovascular disease of La Alianza-Hospital Central of Barcelona]. , 1993, Medicina clinica.

[39]  P. Wolf,et al.  Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. , 1991, Stroke.

[40]  Robert A. Zimmerman,et al.  Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. , 1990, Stroke.

[41]  Daniel B Hier,et al.  The Stroke Data Bank: design, methods, and baseline characteristics. , 1988, Stroke.

[42]  J. Matías-Guiu,et al.  Nomenclatura de las enfermedades vasculares cerebrales. , 1987 .

[43]  J. Mohr,et al.  Stroke data banks. , 1986, Stroke.

[44]  M. Galteau,et al.  Data banks. , 1986, Annales de biologie clinique.

[45]  V. Hachinski,et al.  Early Mortality Following Stroke: A Prospective Review , 1984, Stroke.

[46]  A. Belanger,et al.  The Framingham study. , 1976, British medical journal.