Case Fatality Rate of First-Ever Stroke in Erbil City
Keywords:
Stroke, case-fatality, Erbil cityAbstract
Background and objective: Stroke is the third most common cause of death. The objective of this study was to find out the case fatality rate of first-ever stroke in Erbil city.
Methods: This cross-sectional study included 228 first-ever stroke patients hospitalized to teaching hospitals in Erbil city from January, 1st 2009 to August, 31st 2009. Stroke was diagnosed by the consultant internist or neurologist and confirmed by brain CT-scan. Patients were followed-up and one month case-fatality rate was calculated.
Results: The one month case-fatality rate was 23.7% with a higher proportion of deaths occurred in females (26.4%) than in males (21.2%) (P= 0.358). The case-fatality increased with age (P = 0.019); around 75% of deaths occurred in the 7th and 8th decades of life and more than 95% occurred among those 60 years and more. More deaths occurred from haemorrhagic (31.3%) than ischaemic (20.7%) strokes (P= 0.093). The mean ± SD ages of dead and alive were 68.56 ±11.52 and 61.32 ±12.91 years, respectively (P<0.001). Multiple logistic regression revealed significant association of stroke outcome with age (P= 0.037) and atrial fibrillation (P<0.001).
Conclusion: The one month case-fatality rate was relatively comparable to that reported in other developing countries.
Metrics
References
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases. Part I. General considerations, the epidemiologic transition, risk factors and impact of urbanisation. Circulation 2001; 104: 2746-53.
Lawlor DA, Davey-Smith G, Leon DA, Sterne J, Ebrahim S. Secular trends in mortality by stroke subtype in the 20th century: a retrospective analysis. Lancet 2002; 360: 1818-23.
Nicol MB, Thrift AG. Knowledge of risk factors and warning sings of stroke. Vasc Health Risk Manag 2005; 1(2):137-47.
WHO. World health report 2004 changing history. Geneva: WHO. 2004.
Cox AM, McKevitt C, Rudd AG, Wolfe CDA. Socioeconomic status and stroke. Lancet Neurol 2006; 5:181-8.
Allen CMC, Lueck CJ, Dennis M. Neurological diseases. In: Boon AN, Colledge RN, Walker RB, editors. Davidson's principles and practice of medicine. 20th ed. Edinburgh: Churchill Livingstone; 2006. P. 1145-256.
Aminoff MJ, Greenberg DA, Simon RP. Clinical neurology. 6th ed. New York: McGraw-Hill; 2005. P. 285-319.
Park K. Parks textbook of preventive and social medicine. 18th ed. Jabalpur (India): Banarsidas Bhanot Publishers; 2005.
Marouf IT. Quality of life and morbidity pattern of a sample of geriatric population in Erbil city. M.Sc. thesis. Hawler Medical University. College of Medicine. Iraq. 2008.
Hanlon P, Byers M, Walker BR, Summerton C. Nutrition, metabolic and environmental disease. In: Boon AN, Colledge RN, Walker RB, editors. Davidson's principles and practice of medicine. 20th ed. Edinburgh: Churchill Livingstone; 2006. P. 93-129.
Frier BM, Fisher M. Diabetes mellitus. In: Boon NA, Colledge NR, Walker BR editors. Davidson’s principles & practice of medicine. 20th ed. Edinburgh: Churchill Livingstone Elsevier; 2006. P. 805-47.
WHO, COSIT. National survey for NCD risk factors for population age 25-65 years old / Iraq. Geneva: WHO. 2006.
Hennekens CH, Buring JE. Epidemiology in medicine. 3rd ed. Boston, USA: Little, Brown and Company; 1987.
Gordis L. Epidemiology. Philadelphia.USA. W.B. Saunders; 1996. P. 30-88.
Mawlood FJ. Prevalence of stroke in Hawler city: A household survey. Diploma thesis. Hawler Medical University. College of Medicine. Iraq. 2009.
Khidhir AJ. Risk factors, subtypes and clinical outcome of patients with acute stroke admitted to Erbil teaching hospitals from 1st June 2003 to 1st Feb 2004. Diploma thesis. Salahaddin University, College of Medicine. Iraq, 2004.
Wolfe CDA, Corbin DOC, Smeeton NC, Gay GHE, Rudd AG, Hennis AJ et al. Post stroke survival for Black-Caribbean population in Barbados and South London. Stroke 2006; 37: 1991-6.
Hussein ST. Risk factors for stroke. A case - control study. M.Sc. thesis. University of Mosul, College of Medicine. Iraq, 1993.
Oveisgharan S, Sarrafzadegan N, Shirani S, Hosseini S, Hasanzadeh P, Khosravi A. Stroke in Isfahan, Iran: Hospital admission and 28-day case fatality rate. Cerebrovasc Dis 2007; 24: 495-9.
Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS et al. Incidence, types, risk factors, and outcome of stroke in a developing country: The Trivandrum, Kerala, India. Stroke 2009; 40 (4): 1212-8.
Sagui E, M’Baye PS, Dubecq C, Fall KB, Niang A, Gning S et al: Ischemic and hemorrhagic strokes in Dakar, Senegal: a hospital-based study. Stroke 2005; 36:1844-7.
Walker RW, Rolfe M, Kelly PJ, George MO, James OFW. Mortality and recovery after stroke in Gambia. Stroke 2003; 34:1604-9.
Wang Y, Levi CR, Attia JR, D'Este CA, Spratt N, Fisher J. Seasonal variation in stroke in the Hunter Region, Australia: a 5-year hospital-based study, 1995-2000. Stroke 2003; 34: 1144-50.
Lavados PM, Sacks C, Prina L, Escobar A, Tossi C, Araya F et al. Incidence, 30 day case fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study. Lancet 2005; 365: 2206-15.
Smadja D, Cabre P, May F, Fanon JL, Rene-Corail P, Riocreux C et al. Epidemiology of stroke in Martinique, French West Indies. Part I. Methodology, incidence, and 30-day case fatality rate. Stroke 2001; 32: 2741-7.
Liu X, Xu G, Wu W, Zhang R, Yin Q, Zhu W. Subtypes and one-year survival of first-ever stroke in Chinese patients. Cerebrovasc Dis 2006; 22: 130-6.
Powles J, Kirov P, Feschieva N, Stanoev M, Atanasova V. Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a 'hot pursuit' study. BMC Public Health (online) 2002; 2: 24. [about 19 pages] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC130018/. (Accessed 3 Oct 2009).
Vibo R, Kôrv J, Roose M. The Third Stroke Registry in Tartu, Estonia: decline of stroke incidence and 28-day case-fatality rate since 1991. Stroke 2005; 36:2544-8.
Hallström B, Jönsson AC, Nerbrand C, Norrving B, Lindgren A. Stroke incidence and survival in the beginning of the 21st century in Southern Sweden. Comparisons with the late 20th century and projections into the future. Stroke 2008; 39:10-15.
Musolino R, La Spina P, Serra S, Postorino P, Calabró S, Savica R et al. First-ever stroke incidence and 30-day case fatality in the Sicilian Aeolian archipelago, Italy. Stroke 2005; 36: 2738-41.
Appelros P, Stegmayr B, Terent A. Sex differences in stroke epidemiology. Stroke 2009; 40 (4): 1082-90.
Sacco S, Marini C, Toni D, Olivieri L, Carolei A. Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke 2009; 40(2):394-9
Thorvaldsen P, Davidsen M, Brønnum-Hansen H, Schroll M. Stable stroke occurrence despite incidence reduction in an aging population. Stroke 1999; 30: 2529-34.
Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol 2007; 6:182-7.
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