Incidence, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS project)
Incidence, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS project)
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DOI：
10.1016/s0140-6736(05)66779-7
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发表时间：
2005-06-25
期刊：
影响因子：
168.9
通讯作者：
Alvarez, G
中科院分区：
文献类型：
--
作者：
Lavados, PM;Sacks, C;Alvarez, G
背景 拉丁美洲人群中卒中的流行病学以及不同社区之间亚型的差异尚不清楚。我们的目的是前瞻性地确定智利北部沙漠地区城市伊基克的西班牙裔混血人口中首次中风的发病率。方法我们从几个重叠的来源前瞻性地确定了2000年7月1日至2002年6月30日期间所有可能的中风和短暂性脑缺血发作病例。两名现场神经科医生对患者进行了快速评估。使用事件病例、中风、短暂性脑缺血发作、病理类型和梗死亚型的标准定义。所有确定的病例均由至少两名中风神经科医生进行裁决，并进行 6 个月的随访。根据 2002 年全国人口普查，根据伊基克人口 (214 526) 计算首次中风发病率。调查结果 在已确定的 380 例中风病例中，有 292 例是突发中风。 267 名 (91%) 患者进行了 CT 扫描，平均扫描时间为 2.2 天。入院率为71%（207/292）。首次卒中的总体年龄调整发病率为每 10 万人 140.1 例（95% CI 124.0-156.2）。按病理类型每10万人的发病率为：梗塞87.3例，脑出血27.6例，蛛网膜下腔出血6.2例。 30 天和 6 个月的病死率分别为 23.3% 和 33.0%。 解释 我们的结果显示中风的发病率与其他社区研究中报告的相似。尽管脑内出血的比例高于之前研究报告的比例，但总体发病率却并非如此，这可能表明该人群的缺血性中风发病率略低于其他国家。预后与其他基于人群的研究中发现的结果相似。
Background The epidemiology of stroke in Latin-American populations and variation of subtypes between communities are unclear. Our aim was to ascertain prospectively the incidence of first-ever stroke in the predominantly Hispanic-Mestizo population of Iquique, a city in the northern desert region of Chile.Methods We prospectively identified all possible cases of stroke and transient ischaemic attacks between July 1, 2000, and June 30, 2002, from several overlapping sources. Patients were rapidly assessed by two field neurologists. Standard definitions for incident cases, stroke, transient ischaemic attack, pathological type, and infarction subtype were used. All cases identified were adjudicated by at least two stroke neurologists and followed up at 6 months. Incidence rates of first-ever strokes were calculated from the population of Iquique (214 526) according to the national census of 2002.Findings Of 380 cases of stroke identified, 292 were incident. CT scans were done in 267 (91%) patients and the mean time to scan was 2.2 days. The hospital admission rate was 71% (207/292). The overall age-adjusted incidence rate of first-ever stroke was 140.1 per 100 000 (95% CI 124.0-156.2). The incidence rates per 100 000 according to pathological type were: infarcts 87.3, intracerebral haemorrhage 27.6, and subarachnoid haemorrhage 6.2. The 30-day and 6-month case-fatality rates were 23.3% and 33.0%, respectively.Interpretation Our results show incidence rates of stroke similar to those reported in other community studies. Although the proportion of intracerebral haemorrhages was higher than reported in previous studies, the overall incidence was not, which could indicate a slightly lower incidence of ischaemic strokes in this population than in other countries. The prognosis was similar to that found in other population-based studies.