Jeyaraj D Pandian1, Gagandeep Singh2, Paramdeep Kaur2, Rajinder Bansal2, Birinder S Paul2, Monika Singla2, Shavinder Singh2, Clarence J Samuel2, Shweta J Verma2, Premjeeth Moodbidri2, Gagandeep Mehmi2, Amber Sharma2, Om P Arora2, Arun K Dhanuka2, Manoj K Sobti2, Harish Sehgal2, Mohanjeet Kaur2, Sarvpreet S Grewal2, Sukhdeep S Jhawar2, T N Shadangi2, Tushar Arora2, Ashish Saxena2, Gaurav Sachdeva2, Jeetamol S Gill2, Ramandeep S Brar2, Anakhvir Gill2, Sandeep S Bakshi2, Sandeep S Pawar2, Gurmeet Singh2, Praveen Sikka2, Pradeep K Litoria2, Meenakshi Sharma2. 1. From the Stroke Unit (J.D.P., P.K., S.J.V., P.M., G.M., A. Sharma), Department of Neurology, Christian Medical College and Hospital; Department of Neurology (G. Singh, R.B., B.S.P., M. Singla), Dayanand Medical College and Hospital; Departments of Community Medicine (S. Singh, C.J.S.) and Neurosurgery (S.S.G., S.S.J.), Christian Medical College; Arora Neuro Center (O.P.A.); Deep Hospital (A.K.D.); Sobti Neuro and Super Specialty Hospital (M.K.S.); Guru Teg Bahadur Charitable Hospital (H.S.); Shree Raghunath Hospital (M.K.); Deepak Hospital (T.N.S., T.A.); Mediciti Hospital (A. Saxena, G. Sachdeva); Delta Heart Center (J.S.G., R.S.B.); Heart Beat Diagnostic Center (A.G.); Ace Healthways (S.S.B.); Kuka Diagnostic Center (S.S.P.); Civil Hospital (G. Singh); ESIC Hospital (P.S.); Geology, Water Resources and Geoinformatic Division (P.K.L.), Punjab Remote Sensing Center, Ludhiana; and Non Communicable Diseases Division (M. Sharma), Indian Council of Medical Research, New Delhi. jeyarajpandian@hotmail.com. 2. From the Stroke Unit (J.D.P., P.K., S.J.V., P.M., G.M., A. Sharma), Department of Neurology, Christian Medical College and Hospital; Department of Neurology (G. Singh, R.B., B.S.P., M. Singla), Dayanand Medical College and Hospital; Departments of Community Medicine (S. Singh, C.J.S.) and Neurosurgery (S.S.G., S.S.J.), Christian Medical College; Arora Neuro Center (O.P.A.); Deep Hospital (A.K.D.); Sobti Neuro and Super Specialty Hospital (M.K.S.); Guru Teg Bahadur Charitable Hospital (H.S.); Shree Raghunath Hospital (M.K.); Deepak Hospital (T.N.S., T.A.); Mediciti Hospital (A. Saxena, G. Sachdeva); Delta Heart Center (J.S.G., R.S.B.); Heart Beat Diagnostic Center (A.G.); Ace Healthways (S.S.B.); Kuka Diagnostic Center (S.S.P.); Civil Hospital (G. Singh); ESIC Hospital (P.S.); Geology, Water Resources and Geoinformatic Division (P.K.L.), Punjab Remote Sensing Center, Ludhiana; and Non Communicable Diseases Division (M. Sharma), Indian Council of Medical Research, New Delhi.
Abstract
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.
OBJECTIVE: To estimate the incidence, short-term outcome, and spatial distribution of strokepatients 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 strokepatients (≥18 years) were included between March 2010 and March 2013 using WHO Stepwise Approach Surveillance methodology from the city. Strokepatient data were obtained from hospitals, scan centers, and general practitioners, and details of deaths from the Municipal Corporation. RESULTS: Out of 7,199 strokepatients 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. Strokepatient survival is poor in public hospitals. The finding of spatial analysis is of public health significance for stroke prevention and strengthening of stroke services.
Authors: P N Sylaja; Jeyaraj Durai Pandian; Subhash Kaul; M V Padma Srivastava; Dheeraj Khurana; Lee H Schwamm; Praveen Kesav; Deepti Arora; Aman Pannu; Tijy K Thankachan; Aneesh B Singhal Journal: Stroke Date: 2017-11-22 Impact factor: 7.914
Authors: William G Akanksha; Kaur Paramdeep; Singh Gagandeep; Bansal Rajinder; S Paul Birinder; Singla Monika; Singh Shavinder; J Samuel Clarence; J Verma Shweta; Meenakshi Sharma; D Pandian Jeyaraj Journal: Ann Indian Acad Neurol Date: 2017 Jul-Sep Impact factor: 1.383
Authors: Stephanie P Jones; Kamran Baqai; Andrew Clegg; Rachel Georgiou; Cath Harris; Emma-Joy Holland; Yogeshwar Kalkonde; Catherine E Lightbody; Pallab K Maulik; Padma Mv Srivastava; Jeyaraj D Pandian; Patel Kulsum; P N Sylaja; Caroline L Watkins; Maree L Hackett Journal: Int J Stroke Date: 2021-07-02 Impact factor: 5.266