Literature DB >> 23352689

Stroke subtypes and comorbidity among ischemic stroke patients in Brasilia and Cuenca: a Brazilian-Spanish cross-cultural study.

Francisco Javier Carod-Artal1, Jardiel Omar Casanova Lanchipa2, Luis Miguel Cruz Ramírez2, Noelia Sánchez Pérez2, Fátima M Siacara Aguayo2, Isabel Gómez Moreno2, Lourdes Gómez Romero2, Luciene Ferreira Coral3, Daniele Stieven Trizotto3, Clarissa Menezes Moreira3.   

Abstract

BACKGROUND: With the increase in life expectancy worldwide, changes in stroke subtypes and burden of stroke population are expected in both developing and developed countries. Prevalence of stroke subtypes and comorbidity in ischemic stroke patients was assessed in Brasilia, Brazil, and Cuenca, Spain.
METHODS: This was an international (Brazilian-Spanish) cross-sectional study. Stroke subtypes were assessed by means of Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. Modified Rankin scale was used to measure functional recovery and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) was used to assess comorbidity.
RESULTS: A total of 500 patients (mean age 66.2 ± 16.4 years; 48% female; 48.2% Spanish) were included in the study. Spanish patients were significantly older than Brazilian ones (76.4 ± 11.2 versus 56.7 ± 14.6 years; P < .0001). Prevalence of ischemic cardiopathy (20.3% versus 6.2%) and atrial fibrillation (25.7% versus 6.6%) was significantly higher in Spanish stroke patients, whereas they less frequently used tobacco (28.3% versus 52.9%); P less than .0001. Prevalence of stroke subtypes in Spanish and Brazilian stroke patients was: stroke of undetermined etiology (58.1% versus 32.4%), cardioembolism (24.5% versus 11.6%), lacunar infarct (11.6% versus 25.5%), atherothrombotic (3.7% versus 19.7%), and other causes (2.1% versus 10.8%); P less than .0001. The Spanish sample had a significantly higher frequency of comorbidities. The CIRS-G total score and CIRS-G mean number of affected organs significantly increased with age, and correlated with the level of functional dependence as measured by Rankin scale (rS = 0.50; P = .0005).
CONCLUSION: Spanish stroke people had a higher frequency of comorbid conditions, atrial fibrillation, and cardioembolism and these facts were associated with age. Atherothrombotic and lacunar strokes were more common in the younger Brazilian stroke population.
Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Atrial fibrillation; cross-cultural; elderly; health care disparities; stroke; stroke subtypes

Mesh:

Year:  2013        PMID: 23352689     DOI: 10.1016/j.jstrokecerebrovasdis.2012.11.012

Source DB:  PubMed          Journal:  J Stroke Cerebrovasc Dis        ISSN: 1052-3057            Impact factor:   2.136


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