Geographic Information System of Stroke Incidence in Zanjan Province, Iran During 2012-2019 (original) (raw)
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Archives of Iranian Medicine
Background: Despite significant advances in the quality and delivery of specialized stroke care, there still persist remarkable spatial variations in emergency medical services (EMS) transport delays, stroke incidence, and its outcomes. Therefore, it is very important to investigate the possible geographical variations of in-hospital stroke mortality and to identify its associated factors. Methods: This historical cohort study included suspected stroke cases transferred to Ghaem Hospital of Mashhad by the EMS from March 2018 to March 2019. Using emergency mission IDs, the pre-hospital emergency data were integrated with the patient medical records in the hospital. We used the Bayesian approach for estimating the model parameters. Results: Out of 301 patients (142 (47.2%) females vs. 159 (52.8%) males) with a final diagnosis of stroke, 61 (20.3%) cases had in-hospital mortality.Results from Bayesian spatial log-logistic proportional odds (PO) model showed that age (PO=1.07), access r...
2010
Background: The Iranian population is aging rapidly, which causes huge medical concern for health care of this population. This trend will lead to an increase in stroke incidence in the future. The aim of this study was to investigate the epidemiologic patterns, risk factors, length of hospitalization, hospital discharge destination, and case fatality of patients with ischemic stroke from a city of Iran as well as analyses of interaction of these factors. Methods: A cross-sectional, multihospital-based study was performed on all consecutively discharged and diagnosed patients with ischemic stroke in the city of Qom, Iran, between March 2006 and September 2008.
Epidemiology of stroke in Shiraz, Iran
Background: Stroke is the main cause of physical disability and the second leading cause of death worldwide. Two-thirds of all strokes occur in the developing countries. Despite being preventable, stroke is increasingly becoming a major health issue in these countries. The aim of this study was to evaluate the epidemiology of stroke in Shiraz, Iran, one of the main referral centers in the southwestern part of Iran. Methods: A cross-sectional study was conducted on all stroke patients admitted to the Namazee Hospital, affiliated to Shiraz University of Medical Sciences, between August 2010 and January 2011. Patients' demographic data, atherosclerosis risk factors, type of stroke, drug history, outcomes, and neurological signs were recorded. Chi-square test, Kolmogorov-Smirnov test, t-test, and Mann-Whitney U-test were used to analyze the data. Results: A total of 305 patients with stroke, aged 27-97 years (mean ± SD = 68.33 ± 12.99), 269 patients (88.2%) had ischemic stroke (IS) and 36 (11.8%) had hemorrhagic stroke (HS). 133 patients (43.6%) were men and 172 (56.4%) were women. 11.4% of the patients with IS and 40.6% with HS died during hospitalization, causing 12.1% death in all stroke patients [Odds ratio (Or) = 5.34, 95% Confidence intervals (CI) = 2. 35-12.11]. Hypertension, ischemic heart disease, diabetes, and recurrent stroke were the most common risk factors.
Ten-year trend in stroke incidence and its subtypes in Isfahan, Iran during 2003-2013
Background: As there was no evidence of long-term studies on stroke trend, stroke subtypes and its relationships to stroke risk factors and demographic characteristics in Iran, we aimed to evaluate 10-year trend of stroke incidence and stroke subtypes in Isfahan, Iran. Methods: In a hospital-based retrospective study, 24186 cases with the first-ever stroke were analyzed. We assessed the incidence trend of annual stroke and its subtypes [ischemic stroke )IS(, subarachnoid hemorrhage (SAH), and intracranial hemorrhage )ICH(] during the years 2003 to 2013 by sex, and studied the association of demographic and major stroke risk factors with incidence and mortality rate of stroke. Results: The mean age was 69.46 ± 14.87 years, and 49.29% of patients were women. IS was the most frequent type among all the types of strokes (76.18%). Stroke and its subtypes had decreasing incidence trend during the study period, except for SAH that increased. In addition, stroke and its subtypes had decreasing mortality trend during the study period, except for SAH that did not change anymore. Stroke mortality and incidence rates were lower in urban inhabitants compared to residents of rural areas [odds ratio (OR) = 0.763, P < 0.001]. Conclusion: Despite the relatively high incidence of stroke over the study period, the incidence rate of stroke, especially ICH subtype, had a decreasing trend over the last decade in Isfahan. However, given the current young population in Iran, we can expect that the incidence of stroke would have an escalating trend in future.
The Open Public Health Journal, 2022
Background: Stroke is one of the top leading causes of death and disability among adults and the elderly worldwide. Hypertension (HT) and Diabetes Mellitus (DM) are the most common contributory risk factors of stroke, accounting for up to 75% of all cases. This study aimed to investigate the spatial association between sociodemographic and environmental factors and the prevalence of stroke among DM and HT patients in Thailand. Methods: This spatial study applied global Moran's I, the local indicators of spatial association (LISA) and spatial regression to examine the localised associations of sociodemographic and environmental factors and the prevalence of stroke among DM and HT patients in Thailand. Results: The univariate Moran's I scatter plot of the annual prevalence of stroke in Thailand's provinces observed significant positive spatial autocorrelation with the Moran's I value of 0.454 (p < 0.05). The High-High clusters of strokes were mostly located in the center. The Bivariate Moran's I indicated a spatial association between various factors and the prevalence of stroke in which the LISA analysis indicated; 16 Hot-spots or High-High clusters (HH) and 4 Cold-spot or low-low clusters (LL) with alcohol store density, 17 HH and 4 LL clusters with tobacco store density, 9 HH and 9 LL clusters with elderly population density, 5 HH and 3 LL clusters of primary care per population ratio, 16 HH and 3 LL clusters with LST, and 10 HH and 5 LL clusters with NTL. The Spatial Error Model (SEM) of spatial regression analysis has been observed to be the best model that could predict the variation in the prevalence of stroke by 50.80% (R2=0.508). SEM indicated tobacco store density (coefficient=0.065, P<0.05), elderly population density (coefficient=0.013, P<0.001, LST (day) (coefficient=1.417, P<0.05), and NTL (coefficient=0.021, P<0.05) were statistically significant associated with the prevalence of stroke among DM and HT patients in Thailand. Conclusion: Our study observed that the distribution of alcohol stores, density of tobacco stores, concentration of older adults, increasing day temperature and density of NTL were likely to be associated with enhancing the prevalence of stroke in the cluster and neighboring provinces of Thailand. The findings of this study will benefit public sectors or related organizations to develop efficient measures to control stroke.
Incidence, short-term outcome, and spatial distribution of stroke patients in Ludhiana, India
Neurology, 2016
To estimate the incidence, short-term outcome, and spatial distribution of stroke patients and to evaluate the completeness of case ascertainment in Ludhiana. 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. 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) an...
European Stroke Journal
Introduction: The objective of this study is to compare the clinical profile, risk factors, type and outcome of stroke patients in urban and rural areas of Punjab, India. Methods: The primary data source was from the Ludhiana urban population-based stroke registry. The data of first-ever stroke patients with age !18 years were collected using WHO stepwise approach from all hospitals, general practitioners, physiotherapy and scan centres between 26 March 2011 and 25 March 2013. Results: A total of 4989 patients were included and out of 4989 patients, 3469 (69%) were from urban areas. Haemorrhagic stroke was seen more in rural as compared to urban regions (urban 1104 (32%) versus rural 552 (36%); p ¼ 0.01). There were significant differences seen in stroke risk factors; hypertension (urban 1923 (84%) versus rural 926 (89%); p ¼ 0.001) and hyperlipidaemia (urban 397 (18%) versus rural 234 (23%); p ¼ 0.001) between two groups. In the multivariable analysis the rural patients were more likely to be younger (age < 40 years) (
Geography of Stroke Mortality: Hotspotting Areas for Targeted Interventions (P5.009)
2014
OBJECTIVE: We used spatial modeling to identify well-defined areas of the US where stroke related death rates were disproportionately high (hot spots) or low (cold spots). BACKGROUND: Geographic disparities in stroke mortality are well described. To reduce geographic disparities, identification of contiguous areas of the US that have a high burden of cerebrovascular disease is critical. DESIGN/METHODS: US county death data from the 2010 Multiple Cause of Death data files (National Center for Health Statistics) were combined with 2010 Area Resource File demographic data. Stroke deaths were identified using previously described ICD-10 (I60-69). Local tests of spatial autocorrelation (LISA statistic) were conducted in ArcGIS to identify locations where disproportionately high or low stroke death rates were clustered. RESULTS: Across 3133 counties in the United States the median age-adjusted stroke mortality rate for adults (18+) was 59.9 deaths per 100,000 people (IQR 46.8-76.6). There...