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Benković V, Parker M, Novaković T, Meštrović A, Budinčević H. The cost of ischaemic stroke in Croatia. Eur Stroke J 2023; 8:21-27. [PMID: 36793741 PMCID: PMC9923131 DOI: 10.1177/23969873221123840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/16/2022] [Indexed: 02/12/2023] Open
Abstract
Objective The aim of this analysis was to estimate 1 year and long-term cost and quality of life of ischaemic stroke patients in Croatia. In addition, we aimed to identify and estimate key categories of costs and outcomes driving the burden of stroke in Croatian healthcare system. Methods Data were derived from analysis of the RES-Q Registry for Croatia in 2018 and supplemented with clinical expert opinion and relevant medical, clinical and economic literature to estimate the course of the disease and treatment patterns in Croatian healthcare system. The health economic model was comprised of a one-year discrete event simulation (DES) mapping real life patient experience and a 10-year Markov model built on existing literature. Cost and health resources use were obtained using Croatian tariffs. Health utilities were mapped to EQ5D from the Barthel Index utilising previously published studies. Results The key aspects determining costs and quality of life were rehabilitation, discharge to residential care (currently 13% of patients in Croatia) and recurrent stroke. Total 1 year cost per patient was 18,221 EUR having 0.372 QALYs. Conclusion Direct costing structure of ischaemic stroke in Croatia is above the value of upper-middle income countries. Our study showed that post stroke rehabilitation seems to be a strong modifier of future post-stroke costs and further research into various models of post-stroke care and rehabilitation could be the answer into more successful rehabilitation that could increase QALY and reduce the economic burden of stroke. Further investment in rehabilitation research and provision might bring promising opportunities to improve long term patient outcomes.
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Affiliation(s)
- Vanesa Benković
- Croatian Society for Pharmacoeconomics
and Health Economics, Zagreb, Croatia
| | | | | | - Andrija Meštrović
- Stroke and Intensive Care Unit,
Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia
| | - Hrvoje Budinčević
- Stroke and Intensive Care Unit,
Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia,Faculty of Medicine, Department of
Neurology and Neurosurgery, J.J. Strossmayer University of Osijek, Osijek,
Croatia,Hrvoje Budinčević, Stroke and Intensive
Care Unit, Department of Neurology, Sveti Duh University Hospital, Sveti Duh 64,
Zagreb, 10000, Croatia.
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2
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Sarzyńska-Długosz I. An optimal model of long-term post-stroke care. Front Neurol 2023; 14:1129516. [PMID: 37034084 PMCID: PMC10076665 DOI: 10.3389/fneur.2023.1129516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
Stroke is a major healthcare challenge that is increasing worldwide. The burden of stroke is significant for the affected individuals as well as for the general population; high-quality care is needed to reduce its negative impacts. This article synthesized information from systematic reviews, guidelines, and primary literature on stroke care and post-stroke rehabilitation and proposes an optimal strategy for long-term post-stroke care. It also highlights the unmet needs of patients who experienced a stroke in terms of early diagnosis of complications and adequate, comprehensive therapy.
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3
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Flomin Y, Hetman T, Guliaieva M, Havryliv I, Tsurkalenko O. Determining the etiology of cerebral stroke: from the most prevalent to rare causes. UKRAINIAN INTERVENTIONAL NEURORADIOLOGY AND SURGERY 2022. [DOI: 10.26683/2786-4855-2022-2(40)-14-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cerebral stroke remains the leading cause of death and disability worldwide as well as in Ukraine. After a cerebral stroke, there is an increased risk of a new cerebral stroke (9‒15 % within 1 year), and about a quarter of all cerebral stroke are recurrent. Up to 80 % of recurrent cerebral stroke can be avoided through lifestyle modifications (healthy diet, sufficient amount of physical activity, normalization of body weight, cessation of smoking and alcohol abuse) and control of chronic diseases such as hypertension, diabetes, hyperlipidemia and atrial fibrillation. The key to effective secondary prevention is determining the etiology of cerebral stroke, which requires a primary examination in all cases and a number of additional tests as needed. The most common causes of ischemic cerebral stroke are cardiogenic embolism, atherosclerosis of the large cerebral arteries (macroangiopathy), and brain small vessels disease (microangiopathy), but approximately 1/3 of cerebral stroke have other, rear, determined cause or the cause remains unknown despite the appropriate workup (cryptogenic cerebral stroke). In the review, we discuss modern approaches to ischemic cerebral stroke classification and determination of their etiology, from the most prevalent to the rarest causes. A careful search for the cause of cerebral stroke is particularly important in young patients (aged 18 to 50 years) with a high life expectancy. We have reviewed in detail the possibilities of screening for subclinical atrial fibrillation by long-term cardiac monitoring with implantable devices and the diagnosis of monogenetic causes of cerebral stroke, with a particular focus on Fabry disease, for which there is an effective treatment.
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4
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Phan TG, Haseeb A, Beare R, Srikanth V, Thrift AG, Ma H. Googling the Lifetime Risk of Stroke Around the World. Front Neurol 2020; 11:729. [PMID: 32849202 PMCID: PMC7411741 DOI: 10.3389/fneur.2020.00729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/15/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: We aimed to utilize the data on lifetime risk of stroke, from Global Burden of Disease (GBD) 2016, in combination with open data platforms to create an interactive map for use by clinicians and members of the public. Further, we explore the relationship between life expectancy and lifetime risk of stroke. Design: Enhancing visual display of large volume of data. Setting: Worldwide estimates of the lifetime risk of stroke obtained from the GBD 2016. Participants: None. Intervention: None. Methods: Data were extracted from a portable document format (pdf) copy of the GBD article on the lifetime risk of stroke and exported into the R programming environment (version 3.4.4). These data were merged with (i) the world map boundary, (ii) open data platforms from the World Bank (life expectancy and income), and (ii) open data from the United Nation Population Prospects 2017. Further we plotted the relationship between the adjusted lifetime risk of stroke and life expectancy. Outcomes: The map of the global burden of stroke shows a higher lifetime risk of stroke among high-income countries than in low-income countries (https://gntem3.shinyapps.io/strokeglobal/). The greatest risk was among upper-middle-income countries such as China and Eastern and Central European countries such as Latvia and Romania. The lifetime risk of stroke increased in countries with higher life expectancy (β = 0.48 ± 0.047, 95% confidence interval = 0.390-0.574, R 2 = 0.38, p < 0.01). Conclusion: Overall life expectancy is a major driver of the lifetime risk of stroke. The interactive map enables clinicians to search information about the lifetime risk of stroke interactively and navigate by zooming in and out, while still retaining high resolution.
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Affiliation(s)
- Thanh G Phan
- Department of Neurology, Monash Health, Melbourne, VIC, Australia.,Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Anisha Haseeb
- Department of Neurology, Monash Health, Melbourne, VIC, Australia.,Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Richard Beare
- Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Velandai Srikanth
- Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Amanda G Thrift
- Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Henry Ma
- Department of Neurology, Monash Health, Melbourne, VIC, Australia.,Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
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5
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Uivarosan D, Bungau S, Tit DM, Moisa C, Fratila O, Rus M, Bratu OG, Diaconu CC, Pantis C. Financial Burden of Stroke Reflected in a Pilot Center for the Implementation of Thrombolysis. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E54. [PMID: 32013001 PMCID: PMC7074434 DOI: 10.3390/medicina56020054] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/06/2020] [Accepted: 01/27/2020] [Indexed: 01/01/2023]
Abstract
Stroke represents a serious illness and is extremely relevant from the public health point of view, implying important social and economic burdens. Introducing new procedures or therapies that reduce the costs both in the acute phase of the disease and in the long term becomes a priority for health systems worldwide. The present study quantifies and compares the direct costs for ischemic stroke in patients with thrombolysis treatment versus conservative treatment over a 24-month period from the initial diagnosis, in one of the 7 national pilot centres for the implementation of thrombolytic treatment. The significant reduction (p < 0.001) of the hospitalization period, especially of the days in the intensive care unit (ICU) for stroke, resulted in a significant reduction (p < 0.001) of the total average costs in the patients with thrombolysis, both at the first hospitalization and for the subsequent hospitalizations, during the period followed in the study. It was also found that the percentage of patients who were re-hospitalized within the first 24-months after stroke was significantly lower (p < 0.001) among thrombolyzed patients. The present study demonstrates that the quick intervention in cases of stroke is an efficient policy regarding costs, of Romanian Public Health System, Romania being the country with the highest rates of new strokes and deaths due to stroke in Europe.
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Affiliation(s)
- Diana Uivarosan
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania; (D.M.T.); (C.M.)
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania; (D.M.T.); (C.M.)
| | - Corina Moisa
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania; (D.M.T.); (C.M.)
| | - Ovidiu Fratila
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (O.F.); (M.R.)
| | - Marius Rus
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (O.F.); (M.R.)
| | - Ovidiu Gabriel Bratu
- Clinical Department 3, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
| | - Camelia C. Diaconu
- Department 5, University of Medicine and Pharmacy ”Carol Davila”, 050474 Bucharest, Romania;
- Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Carmen Pantis
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
- Emergency Clinical County Hospital, 410169 Oradea, Romania
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6
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Ioacara S, Tiu C, Panea C, Nicolae H, Sava E, Martin S, Fica S. Stroke Mortality Rates and Trends in Romania, 1994-2017. J Stroke Cerebrovasc Dis 2019; 28:104431. [PMID: 31624036 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/15/2019] [Accepted: 09/20/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND AIM Romanian national level stroke mortality data is relatively scarce. The current study investigated stroke mortality rates and trends in Romania. METHODS All individual deaths registered in Romania during 1994-2017 were analyzed using an anonymized database, based on death certificates. Stroke crude mortality rates (CMR) and age-standardized mortality rates (ASMR) were calculated and expressed per 100,000 persons-year. RESULTS Between 1994 and 2017, 6,281,873 persons died in Romania, stroke being registered as the underlying cause of death in 959,319 cases. The overall stroke CMR was 188.2 (199.3 for women and 176.5 for men). The CMR for hemorrhagic stroke (HEMS) was 32.4 and for ischemic stroke (ISCS) 10.9. There was a significant decrease in stroke ASMR from 344.4 (95% confidence interval [CI] 343.4-345.4) in 1994 to 192.1 (95% CI 191.5-192.7) in 2017, with an annual percent change (APC) of 2.53% per year (95% CI 2.50-2.55, P < .001). Although compared with men, women had higher CMRs, when those rates were age-standardized men had higher ASMR as compared with women. The decline in HEMS ASMR had an APC of 4.65% per year (95% CI 4.59-4.70, P < .001). ISCS ASMR showed an initial increase in ASMR during 1994-2005, with APC 6.39% per year (95% CI 6.09-6.70, P < .001), followed by a significant decrease until 2017, with APC 2.83% per year (95% CI 2.59-3.07, P < .001). CONCLUSION There was a significant reduction in stroke ASMR during 1994-2017. The decline was slow until 2002 and became steeper after that, with significant differences in gender analysis.
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Affiliation(s)
- Sorin Ioacara
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Elias" University Emergency Hospital, Bucharest, Romania
| | - Cristina Tiu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; University Emergency Hospital, Bucharest, Romania.
| | - Cristina Panea
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Elias" University Emergency Hospital, Bucharest, Romania
| | - Horia Nicolae
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Elias" University Emergency Hospital, Bucharest, Romania
| | - Elisabeta Sava
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Elias" University Emergency Hospital, Bucharest, Romania
| | - Sorina Martin
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Elias" University Emergency Hospital, Bucharest, Romania
| | - Simona Fica
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Elias" University Emergency Hospital, Bucharest, Romania
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7
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Świeżewski SP, Rzońca P, Panczyk M, Leszczyński PK, Gujski M, Michalak G, Fronczak A, Gałązkowski R. Polish Helicopter Emergency Medical Service (HEMS) Response to Stroke: A Five-Year Retrospective Study. Med Sci Monit 2019; 25:6547-6553. [PMID: 31473759 PMCID: PMC6738001 DOI: 10.12659/msm.915759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background A stroke is a serious life-threatening emergency that requires immediate intervention in an appropriate therapeutic center. The aim of this study was to analyze the time of medical procedures at the scene and changes in the state of stroke patients during transport by HEMS in Poland. The presented research is the first nationwide study covering such a large group of stroke patients, for whom aerial support was used in the therapeutic process. Material/Methods A retrospective cross-sectional study of 48553 missions performed by Polish Medical Air Rescue (PMAR) during the 5-year study period resulted in 3906 stroke patients who, after medical rescue operations by HEMS crew, were transported by helicopters to hospitals. Results Helicopters in 3475 (88.97%) cases were utilized as a support for Ground Emergency Medical Service (GEMS). The maximum duration of HEMS operation from activation to patient transfer to the hospital did not exceed 108 min and the median was 60 min. Over 87% of patients with HEMS reported stroke symptoms and arrived at the medical center with the possibility of implementing thrombolytic therapy. The factor that affected the deterioration of patients’ condition was the drawing out of the extent of time spent by the crew at the scene. Conclusions The use of HEMS in Poland in the case of patients with stroke symptoms ensures fast and professional assistance at the site of the medical emergency as well as safe transport to specialized centers, shortening the time of proper treatment implementation.
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Affiliation(s)
- Stanisław Paweł Świeżewski
- Department of Emergency Medical Services, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.,Polish Medical Air Rescue, Warsaw, Poland
| | - Patryk Rzońca
- Polish Medical Air Rescue, Warsaw, Poland.,Department of Emergency Medicine, Medical University of Lublin, Lublin, Poland
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Konrad Leszczyński
- Department of Nursing and Emergency Medicine, Faculty of Health Sciences, University of Natural Sciences and Humanities, Siedlce, Poland
| | - Mariusz Gujski
- Chair of Public and Environmental Health, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Michalak
- Department of Emergency Medical Services, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.,Polish Medical Air Rescue, Warsaw, Poland
| | - Adam Fronczak
- Department of Public Health, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Robert Gałązkowski
- Department of Emergency Medical Services, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.,Polish Medical Air Rescue, Warsaw, Poland
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8
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Nursi A, Padrik M, Nursi L, Pähkel M, Virkunen L, Küttim-Rips A, Taba P. Adaption and validation of the Mississippi Aphasia Screening Test to Estonian speakers with aphasia. Brain Behav 2019; 9:e01188. [PMID: 30569561 PMCID: PMC6346641 DOI: 10.1002/brb3.1188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The Mississippi Aphasia Screening Test (MAST) is a brief screening tool for assessing the expressive and receptive language abilities of patients with aphasia. The goal of this study was to adapt and validate the MAST into the Estonian language. The discriminant validity and internal consistency of the test were examined, as well as its sensitivity and specificity. METHODS The MASTest was administered in 50 left hemisphere stroke patients with aphasia (LHA+ group) in the acute phase after the stroke and 126 healthy volunteers in a control group (CG), stratified by age and level of education. Nonparametric tests were used to get normative values, compare the values of the MASTest scores between the LHA+ group and the CG, and to assess the discriminant validity, internal consistency, sensitivity, and specificity of the MASTest. RESULTS The summary scores: total score (MASTest-T), expressive score (MASTest-E), and receptive score (MASTest-R) correlated with age and educational level, and the normative values were adjusted accordingly. The LHA+ group showed more impairment than the CG in all subtests and summary scores. The internal reliability of the MASTest was high for the whole sample and LHA+ group. The sensitivity and specificity of the MASTest using the 5th percentile were 74% and 94%, respectively, but using receiver operating characteristic (ROC) analysis, it was 89% and 80%. CONCLUSION The MASTest is a valid screening tool for evaluating expressive and receptive language abilities in Estonian patients with aphasia in early stroke. The MASTest is the first validated aphasia screening test for Estonian-speaking people, who number less than one million worldwide.
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Affiliation(s)
- Aaro Nursi
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.,Department of Neurology, Tartu University Hospital, Tartu, Estonia
| | - Marika Padrik
- Institute of Education, University of Tartu, Tartu, Estonia
| | - Liisa Nursi
- Department of Neurology, Tartu University Hospital, Tartu, Estonia
| | - Maarja Pähkel
- Institute of Education, University of Tartu, Tartu, Estonia
| | - Liis Virkunen
- Institute of Education, University of Tartu, Tartu, Estonia
| | | | - Pille Taba
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.,Department of Neurology, Tartu University Hospital, Tartu, Estonia
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9
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Online Information about Stroke - A Soft Challenge for Critical Care Professionals. ACTA ACUST UNITED AC 2018; 4:147-148. [PMID: 30574568 PMCID: PMC6296278 DOI: 10.2478/jccm-2018-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 09/08/2018] [Indexed: 11/20/2022]
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10
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Gierlotka M, Labuz-Roszak B, Wojtyniak B, Lasek-Bal A, Zdrojewski T, Adamczyk-Sowa M, Chwojnicki K, Skrzypek M, Ciesla D, Gasior M. Early and One-Year Outcomes of Acute Stroke in the Industrial Region of Poland During the Decade 2006-2015: The Silesian Stroke Registry. Neuroepidemiology 2018; 50:183-194. [PMID: 29587253 DOI: 10.1159/000487324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 01/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Poland, classified as a high-income country, is still considered to have a high cardiovascular risk population. During the last decade, the standards of care in acute stroke (AS) had markedly improved; thus, we aimed to assess whether and how it translated into early and late outcomes. METHODS Silesian Stroke Registry was created from the administrative database of the public, obligatory, health -insurer in Poland. The AS cases were selected based on primary diagnosis coded in ICD-10 as I60-I64 for years 2006-2015 (n = 120,844). Index hospitalization together with data on re-hospitalizations, procedures, ambulatory visits, rehabilitation and all-cause deaths in a 1-year follow-up were analyzed. RESULTS The rates of admissions per 100,000 adult population varied between 41-47 for haemorrhagic and 257-275 for ischaemic stroke with substantial decrease in almost all age groups except for the oldest patients. In ischaemic stroke, thrombolytic therapy raised from 0 to 8.8% in 2015, along with significant trends of decreasing 30-day (from 20 to 16%) and 12-month (from 35 to 31%) case fatality. In haemorrhagic stroke, case fatality had not changed. After ischaemic stroke, 12-month readmissions due to AS declined from 11-12% in 2006-2009 to 9% in 2010-2014. The percentage of patients benefiting from rehabilitation increased from 24 to 32%. CONCLUSIONS In a large population of industrial province, we showed recent, positive trends in AS admissions, treatment and 1-year outcomes. Development of stroke unit networks and increase in thrombolytic treatment were at least in part responsible for survival improvement and reduction of recurrence of AS. However, case-fatality and stroke recurrence remain high compared to those of other developed countries.
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Affiliation(s)
- Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Beata Labuz-Roszak
- Department of Basic Medical Sciences, Faculty of Public Health, Medical University of Silesia, Katowice, Poland
| | - Bogdan Wojtyniak
- Department-Centre of Monitoring and Analyses of Population Health, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Medical Centre of Upper Silesia, Katowice, Poland
| | - Tomasz Zdrojewski
- Department of Arterial Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Kamil Chwojnicki
- Department of Neurology, Medical University of Gdansk, Gdansk, Poland
| | - Michal Skrzypek
- Department of Biostatistics, Faculty of Public Health, Medical University of Silesia, Katowice, Poland
| | - Daniel Ciesla
- Department of Science, Training and New Medical Technologies, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Mariusz Gasior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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11
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Perovic E, Mrdjen A, Harapin M, Tesija Kuna A, Simundic AM. Diagnostic and prognostic role of resistin and copeptin in acute ischemic stroke. Top Stroke Rehabil 2017; 24:614-618. [DOI: 10.1080/10749357.2017.1367454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Edi Perovic
- Department of Laboratory Diagnostics, General Hospital Zadar, Zadar, Croatia
| | | | - Mladen Harapin
- Department of Radiology, General Hospital Zadar, Zadar, Croatia
| | - Andrea Tesija Kuna
- Clinical Institute of Chemistry, University Hospital Center “Sestre Milosrdnice”, Zagreb, Croatia
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital “Sveti Duh”, Zagreb, Croatia
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12
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Budincevic H, Sremec J, Crnac P, Ostojic V, Galic E, Bielen I. Impact of troponin I on outcome of ischemic stroke patients. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2017; 55:19-22. [PMID: 27622832 DOI: 10.1515/rjim-2016-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Stroke is one of the leading causes of morbidity and mortality. Cardiac troponins have been found to be increased in other conditions apart from the cardiac diseases, such as stroke. The aim of the study was to assess the correlation between elevated troponin I levels and stroke outcome. METHODS This retrospective study included 198 acute ischemic stroke patients in whom troponin I levels have been obtained at admission. Exclusion criteria were concomitant acute coronary syndrome, congestive heart failure, pulmonary embolism, renal failure, rhabdomyolysis and septic conditions. RESULTS There was a statistically significant difference in the proportion of deaths during hospitalization (p = 0.041) and modified Rankin Scale scores (p = 0.016) between the group of patients with elevated troponin I levels and the control group. Prior ischemic strokes were more common in the group with elevated troponin I levels (p = 0.032). No other differences were observed. CONCLUSIONS Our study showed that patients with elevated initial troponin I levels are associated with unfavorable outcome or death. Stroke may be associated with mild elevation of troponin levels, contrary to higher levels which are usually related to other conditions.
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13
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Jurjāns K, Noviks I, Volčeka D, Zandersone L, Meilerte K, Miglāne E, Stepens A, Millers A. The adaption and evaluation of a Latvian version of the National Institutes of Health Stroke Scale. J Int Med Res 2016; 45:1861-1869. [PMID: 28703630 PMCID: PMC5805183 DOI: 10.1177/0300060516664636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives To determine the validity and reliability of a Latvian version of the National Institutes of Health Stroke Scale (LV-NIHSS) for evaluating Latvian stroke patients. Methods The adaption of the LV-NIHSS followed standard methods used for the adaption and validation of clinical assessment tools. The scale validity was tested by comparison with the Glasgow Coma Scale (GCS) and the modified Rankin scale (mRs). The reliability of the LV-NIHSS was evaluated by intra-rater and inter-rater agreement using intra-class correlation coefficient (ICC) analysis. Results A total of 296 stroke patients and 101 control subjects were evaluated. The mean age of the overall study population was 73.6 years (range, 37 - 94 years; 227 [57.2%] were female). The mean LV-NIHSS score of the patients with stroke was 8.4 ± 6.2. In terms of construct validity of the LV-NIHSS, it correlated with the GCS ( r = -0.571) and mRs ( r = 0.755). In terms of the reliability of the LV-NIHSS, the inter-rater agreement had an ICC of 0.99 and the intra-rater agreement had an ICC of 0.99. Conclusion The adaption of LV-NIHSS was successful and the evaluation showed that the scale was valid and reliable for evaluating Latvian stroke patients.
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Affiliation(s)
- Kristaps Jurjāns
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia.,2 Department of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Iļja Noviks
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia.,2 Department of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Diāna Volčeka
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | - Linda Zandersone
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | - Kristīne Meilerte
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | - Evija Miglāne
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia.,2 Department of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Ainars Stepens
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | - Andrejs Millers
- 1 Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia.,2 Department of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia
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