Frequency Of Stroke In Patients Research Articles

Disability assessment due to stroke

Objectives: The main purpose of the study is to determine the frequency of stroke in patients who applied to the disability board. The secondary aim of the study is to determine the factors affecting disability rates in patients who applied to the disability board due to stroke. Methods: Patients over the age of 18 who applied to the physical nedicine and rehabilitation outpatient clinic for disability assessment were included in the study. Disability board files of all patients were scanned retrospectively and the information obtained was recorded. Results: It was found that 9.1% of patients who were evaluated for disability and were found to have any level of disability experienced disability due to stroke. A statistically significant relationship was found between stroke-related disability score and advanced age, female gender, and the presence of aphasia and dementia in the patients (p < 0.05). However, no statistically significant relationship was found between the type of stroke, the affected side and the stroke-related disability scores (p > 0.05). Conclusions: Stroke patients constitute a remarkable part of disability assessment. When evaluating stroke patients in terms of their disability, comorbid diseases and demographic characteristics of the patients should also be taken into consideration.

This Month in Anesthesiology

This Month in Anesthesiology

Abstract #1325490: The Frequency of Stroke in Patients with Diabetes Mellitus During Fasting Ramadan Compared to the Remaining Months of the Year in Khartoum State, 2017-2018

To study the frequency of stroke in patients with diabetes admitted during the month of Ramadan compared to the other months of the year. We sought to determine the frequency of stroke in patients with DM in relation to the demographics of the population studied and to determine risk factors of stroke during the month of Ramadan as compared with the remaining months of the year.

The impact of mitral regurgitation on the incidence of stroke in patients with atrial fibrillation

Abstract Background Stroke is a significant cause of mortality and a leading cause of disability in elderly patients. Atrial fibrillation (Af) is the most common cardiac disease with assumed embolic stroke. Therefore, patients with Af need anti-coagulant therapy with a Warfarin (vitamin K antagonist) or a DOAC (Direct Oral Anti-Coagulant), also considering the risk and benefit net balance. It has been suggested that significant mitral regurgitation (MR) and its vortex jet in the left atrium might reduce embolic stroke source in patients with Af. However, the effect of MR on the risk of stroke in patients with Af is still controversial. Therefore, we hypothesized whether MR might be associated with a lower risk of thromboembolic events in patients with Af. Purpose This study aims to investigate whether MR was associated with a decreased risk of stroke in patients with Af, especially in the elderly population. Methods We studied 1,714,955 patients in the LIFE Study database, comprising Japanese claims data for public insurance policyholders between 2014 and 2020. We identified 51,939 patients with new-onset Af. Among them, patients with pre-existing stroke patients (N=28,519) were excluded, and new-onset Af patients without stroke (N=23,420) were obtained. Based on the baseline information, the Af patients were stratified into the MR group (N=3,439) and Without-MR group (N=19,981). Propensity score matching (the nearest neighbor method with a caliper of 0.2) was performed to balance baseline features and stroke risk factors between the MR group (N=3439) and the Without-MR group (N=3439). Propensity scores were estimated using logistic regression with age, sex, and all factors in Elixhauser's comorbidity system. The incidence rate of the stroke (events per person-year) was calculated by the event numbers divided by the overall period for the observations months × 12. Kaplan-Meier curves of stroke-free survival were generated, and the two groups' comparisons were performed using the log-rank test. Results As expected, patients' characteristics were comparable between the two groups. The observation period was 3 years for both groups. In the MR group, 136 patients with stroke were detected. On the other hand, 122 patients with stroke were detected in the Without-MR group. The incidence rate of the stroke per person-year was 0.027 and 0.025 events per person-year in patients with the MR and Without-MR groups. In addition, the Kaplan-Meier analysis showed that the incidence rate of stroke was comparable between the two groups (P=0.43). Conclusions The frequency of stroke in patients with atrial fibrillation was similar, despite mitral regurgitation. Therefore, patients with atrial fibrillation should have anti-coagulation therapy, regardless of the presence or absence of mitral regurgitation. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by grants provided by the Japan Science and Technology Agency (JST) Fusion Oriented Research for disruptive Science and Technology (FOREST) Program (Grant Number: JPMJFR205J) and the Japan Society for the Promotion of Science (JSPS) Grants-in-Aid for Scientific Research (KAKENHI) Program (Grant Numbers: JP20H00563 and JP19K21590).

Epidemiology of atrial fibrillation in ischaemic stroke patients: a population-based study in Auckland, New Zealand

This oral presentation aims to discuss the results of my research on the incidence and attack rates of first-ever ischaemic stroke in patients with atrial fibrillation. Stroke is one of the most prevalent causes of death and debilitating neurological conditions. Globally, the absolute number of stroke patients is rising, with high-income countries showing a higher stroke prevalence than low- and middle-income countries. Atrial fibrillation is one of the most common cardiac arrhythmia and a well-known risk factor for ischaemic stroke. It is associated with a five-fold increase in ischaemic stroke risk, more likely to be severe or fatal. In New Zealand, there have been no previous population-based incidence studies of ischaemic stroke in patients with atrial fibrillation. The design of this study allowed, for the first time, an accurate estimation of the frequency of ischaemic stroke in patients with atrial fibrillation, identifying knowledge gaps specific to New Zealand and providing essential information for health policy development. In this study, the pre-stroke prevalence of atrial fibrillation appeared to be very high and was strongly associated with established cardiovascular risk factors. During the study period, the crude incidence rate of first-ever ischaemic stroke in atrial fibrillation patients in the Auckland population was higher than that reported in other population-based studies. The aging of the population could partlyexplain the increasing incidence of ischaemic stroke associated with atrial fibrillation in developed countries, including New Zealand. The atrial fibrillation detection at the time of stroke onset was significantly improved by using historical hospital archives. Moreover, a longer post-stroke duration of electrocardiographic monitoring was associated with higher newly diagnosed atrial fibrillation detection, demonstrating that prolonged monitoring should be considered for all stroke survivors.

Frequency of ischemic stroke in patients with bacterial meningitis visiting to Jinnah Postgraduate Medical Center Karachi. Cross-sectional study

Objective. To determine the frequency of ischemic stroke in patients presenting with bacterial meningitis visiting to JPMC. Material and method. Descriptive cross-sectional study, held in Neurology ward of Jinnah Postgraduate Medical Centre, Karachi, from 20thapril 2018 to 20th October 2018. Patients aged >18 years of either gender with acute bacterial meningitis were included, written informed consent was obtained from all participants and also approval of ethical review committee of the institute was obtained. CT scan brain or MRI brain performed in all the included patients to assess ischemic stroke. All the collected data were recorded on proforma. The data was analyzed using SPSS version 20. Results. 168 patients of bacterial meningitis were included. Mean ± SD of age was 63.48 ±10.53 (61.87-65.08) years. Out of 168 patients, 118 (70.28%) were male and 50 (29.76%) were female. The frequency of ischemic stroke in patients with bacterial meningitis was found to be 22(13.09%). In stratification of age group, 18-40 years and > 40 years, ischemic stroke was found in 4 (6.2%) and 18 (17.3%) patients respectively. In stratification of gender frequency of ischemic stroke in patients with bacterial meningitis in our study was found to be (16.9% among males and 4% among females). Conclusions. The frequency of ischemic stroke in patients with bacterial meningitis was 13.09% and it is associated with poor outcome so high degree of suspicion is necessary for timely diagnosis and treatment of this life threatening complication. Ischemic stroke was found to be significantly more common in old patients as compared to young adults, also more common in males as compared to females.

Abstract P398: Sex Differences in Stroke Frequency in Extracorporeal Cardio-Pulmonary Resuscitation for Refractory Cardiac Arrest

Introduction: Extracorporeal cardio-pulmonary resuscitation (ECPR) is being used more frequently for refractory cardiac arrest (rCA). Stroke remains a key determinant of outcomes in patients receiving ECPR. No studies have yet analyzed sex differences in the frequency of stroke in patients with rCA treated with ECPR. Methods: Retrospective analysis of ECPR cases for rCA identified in the Extracorporeal Life Support Organization (ELSO) International Registry. Age, sex, race/ethnicity and vascular risk factors were included. Stroke was defined as “Ischemic Stroke” and “Intracranial Hemorrhage” as detected by neuroimaging. Statistical analysis: level of significance was set to p≤0.05. To assess sex differences comparative tests were used as appropriate. Results: From 1992 to 2020 a total of 7,460 adult cases of ECPR for rCA were identified; 2,276 (30%) women vs. 5,184 (69%) men; Mean age 50.3 years (±SD 17) in women vs. 54.7 years (±SD 14) in men, (p<0.001). There was no significant difference in hypertension, diabetes, and atrial fibrillation frequency between men and women. Coronary artery disease was more frequent in men than women, 960 (18.5%) vs. 333 (14.6%) respectively (p<0.001). Intracranial hemorrhage occurred in 165 (2.2%) patients in the overall cohort, more frequently in women than men, 69 (3.0%) vs. 96 (1.8%) respectively (p=0.013). Ischemic Stroke occurred in 367 (4.9%) of the overall cohort and more frequently in men than women, 272 (5.2%) vs. 95 (4.1%) respectively (p =0.049). In-hospital mortality occurred in 89 (92.7%) men and 59 (85.5%) women with intracranial hemorrhage (p=0.133), and in 226 (83%) men and 76 (80%) women with ischemic stroke (p=0.497). Conclusions: This is the first study evaluating sex-related differences in the frequency of stroke in patients with ECPR from the largest contemporary ELSO registry. Women were younger than men at the time of rCI and had more intracranial hemorrhages. Men were older and had more ischemic strokes. Morality was high when stroke was present. Our study has implications for future development of sex-targeted treatment strategies when implementing ECPR to reduce neurological complications and to improve outcome.

Epidemiologic Study of the Main Risk Factors for one Year Ischemic Stroke and Surivial in Patients admitted to the neurology department of Ghayim Hospital in Mashhad, Iran, 2015

Introduction: Stroke is the third most common cause of death in developed countries and is the most common neurological disabling disease. Today, several risk factors are known for stroke including lifestyle and risk factors such as hypertension and diabetes which differ in cultures and countries. The aim of this study was to determine the frequency of ischemic stroke in patients admitted to the brain department of Ghaem Hospital in 1395. Methods: In this observational cohort study, 201 cases of ischemic stroke who confirmed by neurologists as well as imaging techniques for diagnosis patients hospitalized to the neurology section of Ghaem Hospital, Mashhad, Iran During 1395. The Patients' information such as age, sex, and The place of living and also the type of stroke and its main risk factors, including history of stroke in the past, hypertension, diabetes mellitus, high blood sugar cigar and high blood lipids were extracted from their records and completed in the checklist. 1 year follow up performed by telephone calling. Data were analyzed and examined by SPSS 21 and statistical tests. Results: According to the analysis, except for the cigarette variable (P-value = 0.003) HDL and TG (P-value = 0.001), no significant relationship was found between the other risk factors of disease risk and sex. In this study, 201 patients with ischemic stroke were studied. The mean age of the participants in the study was 50.92 years. In this study, the prevalence of stroke in men were higher than that of women, 104 (51.7%) for males and 97 (48.3%) for women. In the study of the most important clinical risk factors for stroke, the results showed that the highest prevalence was hypertension in women with 68 (70.1%) and the least of them was smoking with 16 (16.5%). The mean annual death rate in this study was 15.9%, which did not have a significant relationship with sex groups. Conclusion: In this study, hypertension, having diabetes and high blood glucose levels were the most important risk factors for stroke in patients, these results are in accordance with the previous finding studies. Regarding the results, it seems that the control of blood pressure and diabetes is not effectively considered, which requires further investigation.

Effect of Obstructive Sleep Apnea on Frequency of Stroke in Patients With Atrial Fibrillation

Obstructive sleep apnea (OSA) is an independent risk factor for ischemic stroke that is not included in the usual cardioembolic risk assessments for patients with atrial fibrillation (AF). The aim of this study was to investigate the impact of OSA on stroke rate in patients with AF. Patients with AF and new diagnoses of OSA were identified from retrospective chart review. Those with histories of stroke at the time of the sleep study were excluded. The primary outcome was the incidence of stroke, determined by a physician investigator blinded to the results of polysomnography. Subgroup analysis was performed among different CHADS₂ and CHA₂DS₂-VASc scores. Of 5,138 patients screened for OSA, 402 (7.7%) had AF and 332 (6.4%) met the inclusion criteria. Among the study population, the occurrence of first-time stroke was 22.9%. Ischemic stroke was more common in patients with OSA compared with patients without (25.4% vs 8.2% respectively, p = 0.006). After controlling for age, male gender, and coronary artery disease, the association between OSA and stroke remained statistically significant, with an adjusted odds ratio of 3.65 (95% confidence interval 1.252 to 10.623). A positive dose effect of the apnea-hypopnea index on the rate of stroke was observed (p = 0.0045). Subgroup analysis showed significantly higher rates of stroke in patients with CHADS₂ scores of 0 and CHA₂DS₂-VASc scores of 0 and 1 and co-morbid OSA. In conclusion, OSA in patients with AF is an independent predictor of stroke. This association may have important clinical implications in ischemic stroke risk stratification.

Risk of Stroke for Carotid Endarterectomy Patients with Contralateral Carotid Occlusion

The role of a contralateral carotid occlusion in the appearance of neurological complications after carotid endarterectomy (CEA) operations is a matter of some debate. In the North American Symptomatic Carotid Endarterectomy Trial, the risk of perioperative stroke was found to be higher in patients with a contralateral carotid occlusion. In a literature survey in 2004, however, a significantly increased risk of perioperative stroke was found in only one out of 17 studies on contralateral carotid occlusion patients. We therefore examined the frequency of stroke in patients with contralateral carotid occlusion at our own institution and performed a meta-analysis based on 19 representative studies, including the data from our own institution. Out of 1,960 CEAs at the authors' institute, a significantly higher frequency of 5.6% compared to 2.1% (p = 0.012) for perioperative stroke risk was seen in patients with contralateral carotid occlusion compared to those without. The meta-analysis, based on 19 studies, also showed in 13,438 CEA operations a significantly higher perioperative stroke rate of 3.7% compared to 2.4% (p = 0.002) in the presence of a contralateral carotid occlusion. Nevertheless, due to the extremely poor outcomes of medically treated symptomatic patients, a surgical or endovascular procedure should be sought for these patients. Since the superiority of angioplasty/stent procedures has not yet been verified compared to surgical procedures in these patients, special indication for an endovascular procedure should also be taken into consideration.

Stroke in persons with diabetes mellitus in Jos, Nigeria

Mortality and morbidity from stroke in patients with diabetes are on the increase. Epidemiological surveys are most crucial in planning and allocating resources as they provide critical information for good policy formulation in a resource poor country The purpose of this study was to determine the frequency of stroke in patients with diabetes mellitus attending the Medical out Patient unit of Jos University Teaching Hospital. A total of one hundred and twenty Nigerians with diabetes mellitus were consecutively selected and age-sex matched with sixty non-diabetic controls in a ratio of two to one respectively. The mean age of the diabetics was 53.0 +/- 12.4 years while that of the controls was 54.5 +/- 13.9. The mean duration of DM was 8.4 +/- 6.9 years. Sixty five percent of the diabetics had their disease for up to five years. Eight (6.7%) of diabetic patients had ischaemic stroke while 3 (5%) of the controls had stroke. The frequency and risk factors for stroke in persons with diabetes mellitus in Jos, Nigeria are similar to those obtained in other parts of the world. A differing result of hyperlipidaemia as a major determinant for stroke in persons with diabetes mellitus is worth studying in future in a large prospective study.

Prevention of stroke with ticlopidine

We examined the baseline characteristics of patients in the Ticlopidine Aspirin Stroke Study (TASS) to determine if the effects of the two treatments in preventing stroke differed in various subgroups. Patients with the following characteristics did less well on aspirin: elevated creatinine, hypertension or diabetes requiring treatment, or treatment with anticoagulant or antiplatelet drugs prior to their qualifying TIA or stroke. Women and patients with vertebrobasilar symptoms did particularly well on ticlopidine. We performed arteriography in 1,188 patients with carotid qualifying events. The frequency of stroke in patients with abnormal arteriograms ipsilateral to their symptoms was slightly higher than in those with normal carotid arteries. Ticlopidine was more effective in patients without carotid stenosis. Ticlopidine is more effective than aspirin in preventing strokes in patients having warning TIAs. The patients who benefit most from ticlopidine may be women, those who have vertebrobasilar symptoms, those with cerebral ischemic symptoms while on aspirin or anticoagulant therapy, and patients with diffuse atherosclerotic disease rather than high-grade carotid stenosis.