scholarly journals Ischemic stroke in Morocco: a systematic review

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ahmed Kharbach ◽  
Majdouline Obtel ◽  
Laila Lahlou ◽  
Jehanne Aasfara ◽  
Nour Mekaoui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Meta Analysis ◽  
Influential Factors ◽  
Hospital Environment ◽  
Stroke Treatment ◽  
Male Predominance ◽  
Prehospital Delay

Abstract Background The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco. Methods The present work is a systematic review that was conducted according to the recommendations of the “Preferred reporting items for systematic reviews and meta-analysis”. We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients’ proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco. Results Twenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval. Conclusions Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco.

scholarly journals Ischemic stroke in Morocco: A systematic review

2019 ◽  
Author(s):  
Ahmed Kharbach ◽  
Obtel Majdouline ◽  
Laila Lahlou ◽  
Jehanne Aasfara ◽  
Nour Mekaoui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Influential Factors ◽  
Hospital Environment ◽  
Stroke Treatment ◽  
Male Predominance ◽  
Prehospital Delay ◽  
Meta Analyses

Abstract Background: To main objective of this systematic review is to determine; the epidemiological and the etiological profile, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco.Methods: A systematic review was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analyses" (PRISMA) through the consultation of the Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the period between 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206).These studies were assessed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10172 in Acute Stroke Treatment (TOAST), prehospital delay average and it’s influential factors, thrombolyzed patients proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco.Results: Twenty-nine (n = 29) studies were selected. And the average age ranged from 49±15.28 to 67.3 ± 9.91 years. Also, a male predominance was recorded in 13 studies of all ages. High blood pressure, diabetes, smoking and heart disease are the four main risk factors identified throughout the studies. Atherosclerosis and cardioembolic origin seem to be the main etiologies of cerebral ischemia. And the average prehospital time ranged from 26 to 61.95 hours. In addition, the proportion of thrombolyzed patients ranged from 1.8% according to the Azdad et al (2012) study to 2.9% according to the Rachdi’s (2015) study. Finally, the mortality rate in the acute phase varied between 3 and 13%. And the 3-month mortality ranged from 4.30 to 32.5%. It is also important to note that most of studies have a reduced sample size, conduced in hospital environment, and with no confidence interval.Conclusions: Ischemic stroke is affecting more and more the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming, indicating the need to deepen investigations on the determinants that influence patient’s access to care in Morocco in order to improve the management of this pathology.

scholarly journals Ischemic stroke in Morocco: A systematic review

2019 ◽  
Author(s):  
Ahmed Kharbach ◽  
Obtel Majdouline ◽  
Laila Lahlou ◽  
Jehanne Aasfara ◽  
Nour Mekaoui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Acute Stroke ◽  
Influential Factors ◽  
Stroke Treatment ◽  
Male Predominance ◽  
Prehospital Delay ◽  
Acute Stroke Treatment

Abstract Background: The aim of this systematic review is to determine; the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco.Methods: The present work is a systematic review that was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analysis". We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the period between 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10172 in Acute Stroke Treatment, prehospital delay average and it’s influential factors, thrombolyzed patients proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco. Results: Twenty-nine (n = 29) studies were selected. The average age ranged from 49±15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by these studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 hours. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies have a reduced sample size, conducted in hospital environment, and no confidence interval was reported. Conclusions: Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. Indicating, thus, the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco. Key words: Ischemic stroke, Trial of ORG classification 10172 in Acute Stroke Treatment classification, prehospital delay, thrombolysis, Morocco.

Risk Factors for Ischemic Stroke and its Subtypes in Chinese vs. Caucasians: Systematic Review and Meta-Analysis

2015 ◽  
Vol 10 (4) ◽  
pp. 485-493 ◽  
Author(s):  
Chung-Fen Tsai ◽  
Niall Anderson ◽  
Brenda Thomas ◽  
Cathie L. M. Sudlow
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Meta Analysis

scholarly journals Risk factors for 30-day readmission in patients with ischemic stroke: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Zhiqiang Deng ◽  
Xiaoyan Wu ◽  
Linxue Hu ◽  
Ming Li ◽  
Muke Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Meta Analysis

scholarly journals Lack of Associations Between PAI-1 and FXIII Polymorphisms and Arterial Ischemic Stroke in Children: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 25 ◽  
pp. 107602961986950 ◽  
Author(s):  
Beata Sarecka-Hujar ◽  
Ilona Kopyta ◽  
Michał Skrzypek
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Plasminogen Activator ◽  
Meta Analysis ◽  
Plasminogen Activator Inhibitor ◽  
Arterial Ischemic Stroke ◽  
Meta Analyses ◽  
Activator Inhibitor ◽  
Pai 1

The role of genetic risk factors for ischemic stroke seems to be in particular significance in pediatric patients. Numerous polymorphic variants of genes encoding proteins, that is, plasminogen activator inhibitor as well as coagulation factors, involved in the coagulation cascade may be related to arterial ischemic stroke (AIS) both in adults and children. We performed systematic review and 2 meta-analyses to assess possible correlations between common plasminogen activator inhibitor ( PAI-1) and FXIII polymorphisms and ischemic stroke in children. We searched PubMed to identify available data published before October 2018 using appropriate keywords and inclusion criteria. Finally, 12 case–control studies were included: 8 analyzing PAI-1 polymorphism (600 children with stroke and 2152 controls) and 4— FXIII polymorphism (358 children with stroke and 451 controls). R and Comprehensive Meta-Analysis software were used to analyze the impact of the particular polymorphism in the following models: dominant, recessive, additive, and allelic. No publication bias was observed in both meta-analyses. In case of PAI-1 polymorphism, we observed no relation between 4G4G genotype of 4G allele and ischemic stroke in children. We also demonstrated lack of association between FXIII polymorphism and childhood ischemic stroke. In children with AIS, the PAI-1 and FXIII polymorphisms are not risk factors for the disease.

Natural History of Vertebrobasilar Dolichoectatic and Fusiform Aneurysms: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 45 (1-2) ◽  
pp. 68-77 ◽  
Author(s):  
Deena M. Nasr ◽  
Kelly D. Flemming ◽  
Giuseppe Lanzino ◽  
Harry J. Cloft ◽  
David F. Kallmes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Natural History ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Rare Type ◽  
Aneurysm Morphology ◽  
History Of ◽  
Rates Of Growth

Background and Purpose: Vertebrobasilar non-saccular and dolichoectatic aneurysms (VBDA) are a rare type of aneurysm and are generally associated with poor prognosis. In order to better characterize the natural history of VBDAs, we performed a systematic review and meta-analysis of the literature to determine rates of mortality, growth, rupture, ischemia, and intraparenchymal hemorrhage. Materials and Methods: We searched the literature for longitudinal natural history studies of VBDA patients reporting clinical and imaging outcomes. Studied outcomes included annualized rates of growth, rupture, ischemic stroke, intracerebral hemorrhage (ICH), and mortality. We also studied the association between aneurysm morphology (dolichoectatic versus fusiform) and natural history. Meta-analysis was performed using a random-effects model using summary statistics from included studies. Results: Fifteen studies with 827 patients and 5,093 patient-years were included. The overall annual mortality rate among patients with VBDAs was 13%/year (95% CI 8–19). Patients with fusiform aneurysms had a higher mortality rate than those with dolichoectatic aneurysms, but this did not reach statistical significance (12 vs. 8%, p = 0.11). The overall growth rate was 6%/year (95% CI 4–13). Patients with fusiform aneurysms had higher growth rates than those with dolichoectatic aneurysms (12 vs. 3%, p < 0.0001). The overall rupture rate was 3%/year (95% CI 1–5). Patients with fusiform aneurysms had higher rupture rates than those with dolichoectatic aneurysms (3 vs. 0%, p < 0.0001). The overall rate of ischemic stroke was 6%/year (95% CI 4–9). Patients with dolichoectatic aneurysms had higher ischemic stroke rates than those with fusiform aneurysms, but this did not reach statistical significance (8 vs. 4%, p = 0.13). The overall rate of ICH was 2%/year (95% CI 0–8) with no difference in rates between dolichoectatic and fusiform aneurysms (2 vs. 2%, p = 0.65). Conclusion: In general, the natural history of ­VBDAs is poor. However, dolichoectatic and fusiform ­VBDAs appear to have distinct natural histories with substantially higher growth and rupture associated with fusiform aneurysms. These findings suggest that these aneurysms should be considered separate entities. Further studies on the natural history of vertebrobasilar dolichoectatic and fusiform aneurysms with more complete follow-up are needed to better understand the risk factors for progression of these aneurysms.

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