Brain Attack Surveillance in Corpus Christi (BASIC) Project

点击翻译按钮获取中文摘要

Abstract While stroke incidence and mortality are declining in the United States (US), Mexican Americans still have a much higher stroke burden with higher incidence and recurrence, worse neurologic, functional and cognitive outcome, and newly projected higher mortality following stroke. Mexican Americans are the most numerous sub-group of Hispanic Americans, the largest minority population in the US. This important group is aging, growing rapidly, and spreading throughout the country. This renewal application of the Brain Attack Surveillance in Corpus Christi (BASIC) project will facilitate a quarter century population-based examination of stroke trends in Mexican Americans and non-Hispanic whites, including, for the first time, consideration of trends in neurologic, functional, cognitive and quality of life outcomes. This data is crucial for public health planning and monitoring the effectiveness of interventions. The overwhelming majority of stroke patients have long-term sequelae from their stroke that impact their well-being. For the first time, BASIC will investigate outcomes that are important to patients and their caregivers using the Patient-Reported Outcomes Measurement Information System (PROMIS), a well validated tool developed under the auspices of the National Institutes of Health and recommended by a stroke expert panel. This new data collection will yield critical data as the first step in developing interventions to improve stroke outcome and reduce stroke’s impact in Mexican Americans and non-Hispanic whites. Additionally, we will link more than a decade’s worth of data from BASIC with multiple large administrative datasets, including the Texas State Inpatient Research Data File and Emergency Department Dataset and Medicare data, to study ethnic-specific missed opportunities for primary and secondary prevention, such as emergency department visits where atrial fibrillation is noted but not acted upon prior to stroke. We will also examine post-stroke resource utilization to identify areas to improve stroke outcomes and reduce ethnic disparities. In sum, BASIC will continue to provide the only ongoing, uninterrupted stroke surveillance in Mexican Americans; we will focus on ethnic differences and similarities in patient reported outcomes aimed towards designing interventions to improve outcomes; and we will create a stroke “big data” resource combining the strengths of BASIC’s validated stroke events with detailed clinical data and healthcare utilization information from administrative data to prevent stroke and improve outcome. BASIC has amassed a cohort of over 11,000 stroke patients since January 1, 2000, and we add an additional 450 each year. In addition to the rich publication record and numerous spin-off projects, BASIC has just begun to fully take advantage of this precious stroke patient resource.