Incidence, short-term outcome, and spatial distribution of stroke patients in Ludhiana, India
Incidence, short-term outcome, and spatial distribution of stroke patients in Ludhiana, India
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DOI：
10.1212/wnl.0000000000002335
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发表时间：
2016-02-02
期刊：
影响因子：
9.9
通讯作者：
Sharma, Meenakshi
中科院分区：
文献类型：
--
作者：
Pandian, Jeyaraj D.;Singh, Gagandeep;Sharma, Meenakshi
目的：估计卢迪亚纳地区脑卒中患者的发病率、短期预后和空间分布，并评估病例确定的完整性。方法：这项基于人群的前瞻性队列研究在印度西北部旁遮普的卢迪亚纳进行。2010年3月至2013年3月期间，采用世卫组织逐步方法监测方法纳入了该城市所有首次中风患者（18岁）。卒中患者数据来自医院、扫描中心和全科医生，死亡细节来自市政公司。结果：在7199例卒中患者中，3441例纳入最终分析。平均年龄59 - 15岁。年发病率为140/100,000(95%可信区间[CI] 133-147)，年龄调整后发病率为130/100,000 （95% CI 123-137）。年轻人（18-49岁）中风的年发病率为46/10万（95% CI 41-51）。28天病死率为22%。60岁以上患者（p = 0.03）和在公立医院管理的患者生存率较差（p = 0.01）。累积发病热点在城市中南部，结果较差的热点在城市郊区。结论：发病率与印度的其他研究相似。公立医院的中风患者存活率很低。空间分析的发现对卒中预防和加强卒中服务具有公共卫生意义。
Objective:To estimate the incidence, short-term outcome, and spatial distribution of stroke patients and to evaluate the completeness of case ascertainment in Ludhiana.Methods:This population-based prospective cohort study was conducted in Ludhiana, Punjab, Northwest India. All first-ever stroke patients (18 years) were included between March 2010 and March 2013 using WHO Stepwise Approach Surveillance methodology from the city. Stroke patient data were obtained from hospitals, scan centers, and general practitioners, and details of deaths from the Municipal Corporation.Results:Out of 7,199 stroke patients recruited, 3,441 were included in final analysis. The mean age was 59 15 years. The annual incidence rate was 140/100,000 (95% confidence interval [CI] 133-147) and age-adjusted incidence rate was 130/100,000 (95% CI 123-137). The annual incidence rate for stroke in the young (18-49 years) was 46/100,000 (95% CI 41-51). The case fatality at 28 days was 22%. Patients above 60 years of age (p = 0.03) and patients who were managed in public hospitals had poor survival (p = 0.01). Hot spots for cumulative incidence were seen in central and southern parts of the city, and hot spots for poor outcome were seen in the outskirts of the city.Conclusions:The incidence rates are similar to other studies from India. Stroke patient survival is poor in public hospitals. The finding of spatial analysis is of public health significance for stroke prevention and strengthening of stroke services.