Population-Based Stroke Survey in Mumbai, India: Incidence and 28-Day Case Fatality
Population-Based Stroke Survey in Mumbai, India: Incidence and 28-Day Case Fatality
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DOI：
10.1159/000165364
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发表时间：
2008-01-01
影响因子：
5.7
通讯作者：
Mathur, V. D.
中科院分区：
文献类型：
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作者：
Dalal, P. M.;Malik, S.;Mathur, V. D.
目的：本研究的目的是（1）在孟买建立一个前瞻性的基于社区的中风登记处，登记患有“首次中风”（FES）的受试者;（2）收集有关年发病率、中风亚型和2005年和2006年28天病死率的标准化数据。背景资料：据估计，2005年有580万人死于中风（脑血管疾病），其中三分之二来自低收入/中等收入国家，但缺乏可靠的基于人口的研究。方法：世卫组织卒中监测分步方法手册（STEPS Stroke; http://www.who.int/chp/steps/Manual pdf）是操作协议。我们选择了一个定义明确的社区（H区），具有可验证的人口普查数据，并代表孟买（孟买）的人口结构。在337，391名永久居民中，有156，861名年龄在25岁至94岁以上的人有资格接受调查。将对预定义问卷（版本2.0）的回答输入编码数据表中进行分析。结果如下：在两年的研究期间，（2005年1月至2006年12月），456（238名男性和218名女性）患有FES，表明25岁及以上受试者的年发病率为145/10万人（CI 95%：120-170）;男性为149/100 000（CI 95%：120-170），女性为141/100 000（CI 95%：120-160）。采用Segi 1996年世界人口直接法计算的研究人群（男女）年龄标准化率为152/100，000/年（CI 95%：132-172）。在456例FES病例中，407例（89.2%）的卒中诊断得到了计算机断层扫描的支持：366例（80.2%）为缺血性卒中，81例（17.7%）为出血性卒中，9例（1.9%）属于未指明类别。平均年龄为66 +/-（SD）13.60岁，女性年龄大于男性（平均年龄68.9 +/- 13.12岁vs. 63.4 +/- 13.53岁）。病死率：28天时，456例FES病例中有320例（70%）仍存活，136例（29.8%）死亡。在320例存活患者中，38.5%的患者根据改良兰金量表有中度至重度残疾。结论：孟买脑卒中研究采用统一的定义和方法，结果表明，年标化发病率、脑卒中亚型和病死率与发达国家报告的结果非常相似。为了规划有效的干预和预防战略，迫切需要区域人口代表性样本的标准化数据。版权所有（C）2008 S. Karger AG，巴塞尔
Objectives: The aims of this study were (1) to establish a prospective community-based stroke registry in Mumbai of subjects having 'first-ever stroke' (FES) and (2) to collect standardized data on annual incidence, stroke subtypes, and case fatality rate at 28 days during the years 2005 and 2006. Background: An estimated 5.8 million people died from stroke (cerebrovascular disease) in 2005, two thirds of them were from low-/middle-income countries but reliable population-based studies are scarce. Methods: The manual on WHO STEPwise approach to stroke surveillance (STEPS Stroke; http://www.who.int/chp/steps/Manual pdf) was the operational protocol. We selected a well-defined community (H-district) having verifiable census data and being representative of the population structure of Mumbai (Bombay). Of 337,391 permanent residents, 156,861 persons between the age of 25 and 94+ years who were eligible for survey were screened. The responses to a predefined questionnaire (version 2.0) were entered in coded data sheets for analysis. Results: During the 2-year study period (January 2005 to December 2006), 456 (238 males and 218 females) had FES, indicating an annual incidence in subjects of 25 years and above of 145/100,000 persons (CI 95%: 120-170); for males it is 149/100,000 persons (CI 95%: 120-170) and for females it is 141/100,000 persons (CI 95%: 120-160). The agestandardized rate for study population (both sexes) by the direct method using Segi's 1996 world population is 152/100,000/year (CI 95%: 132-172). Stroke diagnosis was supported by computed tomography in 407 (89.2%) of 456 FES cases: 366 (80.2%) had ischemic stroke, 81 (17.7%) had hemorrhagic stroke and 9 (1.9%) were in the unspecified category. The mean age was 66 +/- (SD) 13.60 years, women were older as compared to men (mean age 68.9 +/- 13.12 years vs. 63.4 +/- 13.53 years). Case fatality: at 28 days, 320 (70%) of 456 FES cases were still alive and 136 (29.8%) had died. Of the 320 surviving patients 38.5% had moderate to severe disability by the modified Rankin scale. Conclusions: The results of Mumbai stroke study, using uniform definitions and methodologies, show that the annual standardized incidence rates, stroke subtypes and case fatality rate are very similar to those reported from developed nations. To plan effective intervention and prevention strategies, standardized data in representative samples of regional populations are urgently needed. Copyright (C) 2008 S. Karger AG, Basel