Comparison of Hemorrhagic & Ischemic Stroke Among Blacks and Whites

出血性比较

• 批准号: 7654859
• 负责人: BRETT M KISSELA
• 金额: $ 128.18万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-22 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7654859
• 关键词: Address; African; African American; Area; Autopsy; Awareness; Biometry; Black race; Case Fatality Rates; Censuses; Communities; County; Data; Diffusion weighted imaging; Digit structure; Effectiveness; Epidemiology; Evaluation; Failure; Future; Goals; Group Practice; Health; Health Personnel; Health Services Accessibility; Healthcare; Hospitals; Imaging Techniques; Incidence; Individual; Interview; Ischemic Stroke; Kentucky; Knowledge; Laboratories; Locales; Magnetic Resonance Imaging; Manuals; Measures; Methodology; Methods; Monitor; Neurology; Operative Surgical Procedures; Outcome; Outcome Study; Outcomes Research; Outpatients; Paper; Participant; Patients; Pattern; Persons; Pilot Projects; Population; Populations at Risk; Positioning Attribute; Prevalence; Process; Progress Review Group; Public Health; Public Health Informatics; Qualifying; Quality of life; Race; Research; Research Methodology; Research Personnel; Research Priority; Respondent; Risk; Risk Factors; Science; Screening procedure; Site; Source; Stroke; Surveys; Symptoms; System; Telephone; Telephone Interviews; Testing; Time; Transient Ischemic Attack; Translating; Treatment outcome; United States; Work; acute stroke; base; clinical care; cohort; cost; data exchange; design; experience; follow-up; functional outcomes; high risk; improved; innovation; insight; metropolitan; new technology; novel; population based; population survey; post stroke; prospective; public health relevance; response; success; trend

DESCRIPTION (provided by applicant): We seek to continue our population-based study of stroke incidence, risk factors, treatment, and outcome of stroke within our biracial metropolitan population of 1,349,351, of whom 215,611 (15%) are of black race (US Census 2000). We have studied trends in stroke incidence and case fatality, as well as the prevalence of risk factors and knowledge of stroke (via a population survey) for almost 15 years and have demonstrated a racial disparity where stroke incidence in African-Americans is more than double that of whites. In addition to continuing these important activities, we propose an innovative pilot study that will be the largest prospective, population-based stroke outcomes study to date. The anticipated ~3,200 patients with strokes and 800 TIAs from our region in 2010, as well as the 2,000 surveyed participants, will be used to test the following hypotheses: 1. Temporal trends in the incidence rate of stroke will demonstrate a decrease over time in whites (as shown by our 2005 preliminary data). However, there will not be a similar decrease among blacks, a racial group that has not been examined in other temporal studies of stroke. We expect that case fatality rates will not change between periods, and will be similar for both blacks and whites. 2. A cohort of subjects followed by a regional HIE combined with phone-call follow-up will be more representative of the entire stroke population in our region than a cohort of subjects that agree to in-person interviews, which is likely to have participation and survival biases. Information obtained via this approach will be as valid as data from manual chart abstraction and direct interview for determining access to care and individual patients' functional outcome after stroke across a region, and will be more efficient to collect than that obtained via manual processes. 3. The proportion of the population that knows warning signs or risk factors for stroke will NOT improve between 2006 and 2011, based on our preliminary data. When subjects are asked about their own personal risk for stroke, a lower self-perceived risk will be associated with worse stroke knowledge. PUBLIC HEALTH RELEVANCE: The change in stroke occurrence over time is the ultimate test of how well science has translated new discoveries into benefits for the population. Our study has examined racial disparities in stroke over the last 15 years, showing that blacks have higher risk for stroke than whites. In our population, the occurrence of stroke is decreasing in whites but not African Americans, and we will continue to describe trends in stroke occurrence, cause, treatment, and outcome in a biracial metropolitan population.

描述（由申请人提供）：我们寻求继续在我们的1，349，351名双胞胎大都市人口（其中215，611人（15%）为黑人）中进行基于人群的卒中发病率、风险因素、治疗和卒中结局研究（美国人口普查2000）。我们研究了近15年来中风发病率和病死率的趋势，以及风险因素的患病率和中风知识（通过人口调查），并证明了种族差异，非洲裔美国人的中风发病率是白人的两倍多。除了继续这些重要的活动，我们提出了一个创新的试点研究，这将是最大的前瞻性，基于人群的中风结局研究。预计2010年我们地区约3，200名中风患者和800名TIA患者以及2，000名调查参与者将用于测试以下假设：1.中风发病率的时间趋势将表明白人的发病率随时间的推移而下降（如我们2005年的初步数据所示）。然而，在黑人中不会有类似的下降，这是一个在其他中风时间研究中没有检查过的种族群体。我们预计病死率在不同时期之间不会改变，黑人和白人的病死率也相似。2.一组受试者随后进行区域性HIE并结合电话随访，这比一组同意面对面访谈的受试者更能代表我们地区的整个卒中人群，后者可能存在参与和生存偏倚。通过这种方法获得的信息将与通过手动图表提取和直接访谈获得的数据一样有效，以确定整个地区卒中后获得护理和个体患者的功能结局，并且比通过手动过程获得的信息更有效。3.根据我们的初步数据，在2006年至2011年期间，知道中风警告信号或风险因素的人口比例不会改善。当受试者被问及他们自己的中风风险时，较低的自我感知风险将与较差的中风知识相关。公共卫生关系：随着时间的推移，中风发生率的变化是对科学如何将新发现转化为人口利益的最终考验。我们的研究在过去的15年中检查了中风的种族差异，表明黑人中风的风险高于白人。在我们的人群中，白人而非洲裔美国人的卒中发生率正在下降，我们将继续描述大都市人群中卒中发生率、病因、治疗和结局的趋势。