STROKE INCIDENCE AND PROGNOSIS IN A MIXED ETHNIC REGION

混合民族地区的卒中发病率和预后

• 批准号: 2268059
• 负责人: Ralph L. Sacco
• 金额: $ 72.43万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-01-07 至 1997-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2268059
• 关键词: African American; Hispanic Americans; brain imaging /visualization /scanning; cardiovascular disorder diagnosis; cardiovascular disorder epidemiology; caucasian American; cerebral hemorrhage; disease /disorder classification; disease /disorder proneness /risk; gender difference; human subject; infarct; interview; longitudinal human study; prognosis; racial /ethnic difference; relapse /recurrence; statistics /biometry; stroke; subarachnoid hemorrhage

Mortality data suggest a higher risk of stroke among blacks, but there is little data contrasting stroke incidence, risk and prognosis in blacks, Hispanics and whites in the same population using similar methods. This proposal will provide vital information to help develop targeted stroke prevention strategies in population subgroups which can be used to achieve Health Objective 15.2 of Healthy People 2000 to reduce stroke deaths. This revised prospective, hospital and community based, 5-year study is designed to determine the incidence of symptomatic stroke, the effect of stroke risk factors and the 1-4 year stroke prognosis (stroke recurrence, mortality and myocardial infarction) in white non-Hispanic, black non-Hispanic and Hispanic men and women using the Northern Manhattan population. There are 3 components to this study. First, case surveillance will utilize hospital and community based survey networks for enumeration of all first strokes. Strokes will be classified as intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction which will be subdivided based on the results of diagnostic evaluation. Incidence of stroke subtypes by gender and race/ethnicity will be estimated using the numbers from this study and adjusted 1990 census data. Second, cerebral infarction risk factors will be identified through a case-control study where cases (n=800) are uniformly evaluated first cerebral infarct patients and controls (n=1600) randomly selected from the community for stroke risk factor assessments. All eligible subjects will be enrolled, interviewed and examined. Data will be collected systematically through direct interview of the subject or surrogate on demographics, stroke risk factors, neurological examination, fasting lipid profile and results of diagnostic studies. Finally, prospective, annual in-person and semi-annual telephone follow-up of the cerebral infarct cases will measure stroke recurrence, myocardial infarction and functional outcome. Exploratory univariate analyses will be done to identify variables that are marginally dependent on the outcome of interest and confirmatory multivariate analyses will be performed for hypothesis testing with race/ethnicity and gender as independent variables controlling for other risk factors.

死亡率数据表明，黑人中风的风险较高，但 很少有数据对比黑人的中风发病率、风险和预后， 西班牙裔和白人在同一人群中使用类似的方法。 这 提案将提供重要信息，以帮助制定有针对性的中风 在人口亚组中采取预防战略， 达致2000年健康人健康目标第15.2条，减少中风 死亡 这项修订后的前瞻性、基于医院和社区的5年研究是 旨在确定症状性卒中的发生率， 中风危险因素和1-4年中风预后（中风复发， 死亡率和心肌梗死）在白色非西班牙裔，黑人 使用北方曼哈顿的非西班牙裔和西班牙裔男女 人口 本研究有3个组成部分。第一，案例 监测将利用医院和社区调查网络 用于枚举所有第一笔划。 中风将被归类为 脑内出血、蛛网膜下腔出血或脑梗死 根据诊断评价结果再细分。 将按性别和人种/种族列出卒中亚型的发生率 使用本研究和调整后的1990年人口普查的数字估计 数据 其次，将识别脑梗死危险因素 通过病例对照研究，对病例（n=800）进行统一评价 随机选择首次脑梗死患者和对照组（n=1600） 用于中风风险因素评估。 所有合格 受试者将被招募，面试和检查。 数据将 通过对受试者的直接访谈系统收集，或 人口统计学、中风风险因素、神经系统检查 空腹血脂谱和诊断研究结果。 最后， 前瞻性、每年一次亲自和每半年一次电话随访， 脑梗死病例将测量卒中复发、心肌梗死、 梗死和功能结局。 探索性单变量分析将 要做的，以确定变量是轻微依赖于 关注的结果和验证性多变量分析将是 进行假设检验，人种/种族和性别为 控制其他风险因素的独立变量。