scholarly journals Epidemiology of Stroke in Iran

2016 ◽  
Vol 5 ◽  
pp. 3-9
Author(s):  
Kavian Ghandehari

Numerous hospital-based stroke registries have been developed in Iran during last decade. Khorasan Stroke Registry, Khorasan Posterior Circulation Stroke Registry, Khorasan Pediatric Stroke Registry and Khorasan Stroke in Young Adults Registry are among these published registries. Meanwhile, There is only one epidemiologic deigned study of stroke in Iran and Middle East. Based on this standard epidemiologic study; The crude annual incidence rate of First Ever Stroke (FES) is 139 (95% CI, 128 to 149) per 100 000; for men, 144 (95% CI, 128 to 159), and for women, 133 (95% CI, 118 to 148). The incidence rates increases significantly with each decade of life and is similar in men and women. Subtypes of FES in 81.9%  of patients is ischemic stroke,12.7% is intracerebral hemorrhage, and 2.4% have subarachnoid hemorrhage. The crude annual incidence rate per 100 000 inhabitants is 113 (95% CI, 104 to 123) for ischemic stroke, 18 (95% CI, 14 to 21) for intracerebral hemorrhage and 3 (95% CI, 2 to 5) for subarachnoid hemorrhage. Ischemic strokes are occurring approximately 1 decade earlier in Iran than in other countries.

2018 ◽  
Vol 129 (2) ◽  
pp. 490-497
Author(s):  
Hidetoshi Matsukawa ◽  
Hiroyasu Kamiyama ◽  
Toshiyuki Tsuboi ◽  
Kosumo Noda ◽  
Nakao Ota ◽  
...  

OBJECTIVEOnly a few previous studies have investigated subarachnoid hemorrhage (SAH) after surgical treatment in patients with unruptured intracranial aneurysms (UIAs). Given the improvement in long-term outcomes of embolization, more extensive data are needed concerning the true rupture rates after microsurgery in order to provide reliable information for treatment decisions. The purpose of this study was to investigate the incidence of and risk factors for postoperative SAH in patients with surgically treated UIAs.METHODSData from 702 consecutive patients harboring 852 surgically treated UIAs were evaluated. Surgical treatments included neck clipping (complete or incomplete), coating/wrapping, trapping, proximal occlusion, and bypass surgery. Clippable UIAs were defined as UIAs treated by complete neck clipping. The annual incidence of postoperative SAH and risk factors for SAH were studied using Kaplan-Meier survival analysis and Cox proportional hazards regression models.RESULTSThe patients’ median age was 64 years (interquartile range [IQR] 56–71 years). Of 852 UIAs, 767 were clippable and 85 were not. The mean duration of follow-up was 731 days (SD 380 days). During 1708 aneurysm years, there were 4 episodes of SAH, giving an overall average annual incidence rate of 0.23% (95% CI 0.12%–0.59%) and an average annual incidence rate of 0.065% (95% CI 0.0017%–0.37%) for clippable UIAs (1 episode of SAH, 1552 aneurysm-years). Basilar artery location (adjusted hazard ratio [HR] 23, 95% CI 2.0–255, p = 0.0012) and unclippable UIA status (adjusted HR 15, 95% CI 1.1–215, p = 0.046) were significantly related to postoperative SAH. An excellent outcome (modified Rankin Scale score of 0 or 1) was achieved in 816 (95.7%) of 852 cases overall and in 748 (98%) of 767 clippable UIAs at 12 months.CONCLUSIONSIn this large case series, microsurgical treatment of UIAs was found to be safe and effective. Aneurysm location and unclippable morphologies were related to postoperative SAH in patients with surgically treated UIAs.


2016 ◽  
Vol 18 (12) ◽  
pp. 1013-1022 ◽  
Author(s):  
Mai Inoue ◽  
Atsuhiko Hasegawa ◽  
Katsuaki Sugiura

Objectives The aim of the study was to describe the morbidity pattern of different diagnostic categories in insured cats in Japan by age, sex and breed. Methods The annual incidence rates of having at least one insurance claim were calculated overall and stratified by diagnosis, age, sex and breed using data from insured cats in the period April 2008 to March 2013. Results The overall annual incidence rate of having at least one insurance claim was 4632 (95% confidence interval 4608–4656) cats per 10,000 cat-years at risk. The highest annual incidence rate was obtained for digestive system disorders, followed by urinary tract disorders and dermatological disorders. The incidence rates varied between breeds for most diagnostic categories: for cardiovascular system disorders, Scottish Fold, American Shorthair, Persian, Maine Coon, Norwegian Forest Cat, Ragdoll and Bengal had a higher annual incidence rate than crossbreeds. Conclusions and relevance This study provides comparative and quantitative estimates of morbidity pattern in insured Japanese cats. These estimates can be utilised by veterinary practitioners, breeders and owners in diagnostic decision-making, breeding and when selecting a new pet, respectively.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
João Pinho ◽  
Miguel Quintas-Neves ◽  
Imis Dogan ◽  
Kathrin Reetz ◽  
Arno Reich ◽  
...  

AbstractVascular mechanisms are increasingly recognized in the pathophysiology of Alzheimer’s disease (AD), but less is known about the occurrence of stroke in AD patients. We aimed to quantify the risk of stroke in patients with AD and compare the incidence rates (IR) of stroke in individuals without AD. Systematic search of Embase and MEDLINE between 1970 and 2020. Inclusion criteria: reports with ≥ 50 patients with non-familial AD, which reported the occurrence of stroke (all types) and/or ischemic stroke and/or intracerebral hemorrhage (ICH) during follow-up. Meta-analyses of pooled data using random-effects model were performed. IR were calculated for each study. Incidence rate ratios (IRR) were calculated for studies presenting a control-group without AD. Among 5109 retrieved studies, 29 (0.6%) fulfilled the inclusion criteria, reporting a total of 61,824 AD patients. In AD patients the IR were 15.4/1000 person-years for stroke (all types), 13.0/1000 person-years for ischemic stroke and 3.4/1000 person-years for ICH. When compared to controls without AD, incidence rate for ICH in AD patients was significantly higher (IRR = 1.67, 95%CI 1.43–1.96), but similar for ischemic stroke. Incident stroke is not a rare event in AD population. AD is associated with an increased risk of intracerebral hemorrhage which warrants further clarification.


2021 ◽  
pp. 1-7
Author(s):  
Takako Fujii ◽  
Hisatomi Arima ◽  
Naoyuki Takashima ◽  
Yoshikuni Kita ◽  
Naomi Miyamatsu ◽  
...  

<b><i>Introduction:</i></b> The purpose of this study was to investigate seasonal variation in stroke incidence using data from a large-scale stroke registry of general population in current Japan. <b><i>Methods:</i></b> Shiga Stroke Registry (SSR) is an ongoing population-based registry of stroke that occurred in the Shiga Prefecture in central Honshu, Japan. A total 6,688 cases of first-ever stroke, with onset dates ranging from 1 January 2011 to 31 December in 2013 were included in this study. Incidence rates of first-ever stroke in each season were estimated using the person-year approach and adjusted for age and sex using the Poisson regression models. <b><i>Results:</i></b> From 2011 to 2013, we identified a total of 6,688 stroke cases (3,570 men, 3,118 women), of which 4,480 cases had ischemic stroke (2,518 men, 1,962 women), 1,588 had intracerebral hemorrhage (857 men, 731 women) and 563 had subarachnoid hemorrhage (166 men, 397 women). Age- and sex-adjusted incidence rates of total stroke were 151 (95% confidence interval [CI] 144–160, <i>p</i> = &#x3c;0.001 vs. summer) in spring, 130 (95% CI 122–137) in summer, 141 (95% CI 133–149, <i>p</i> = 0.020 vs. summer) in autumn and 170 (95% CI 161–179, <i>p</i> = &#x3c;0.001 vs. summer) in winter. Seasonal variation was more pronounced in intracerebral hemorrhage than in ischemic stroke. <b><i>Conclusion:</i></b> In the present large-scale stroke registry of general population, incidence rates of stroke were highest in winter and lowest in summer in current Japan.


2021 ◽  
pp. 1-6
Author(s):  
Yannick Béjot ◽  
Gauthier Duloquin ◽  
Quentin Thomas ◽  
Sophie Mohr ◽  
Lucie Garnier ◽  
...  

<b><i>Introduction:</i></b> Stroke is associated with major consequences in terms of socioeconomic impact and lost disability-adjusted life in young victims, thus justifying a careful surveillance of epidemiological trends. This study aimed to assess changes in the incidence of ischemic stroke in young adults over a long period. <b><i>Methods:</i></b> All cases of first-ever ischemic stroke that occurred among adults aged 18–55 years were prospectively recorded using the population-based Dijon Stroke Registry, from 1985 to 2017. Sex-specific annual incidence rates were calculated and were presented according to 6 time periods. Incidence rate ratios (IRRs) were determined to assess sex differences in stroke incidence. <b><i>Results:</i></b> Over the whole study period, 4,451 patients suffered a first-ever ischemic stroke. Among these patients, 469 (10.5%) were young adults (median age: 46 years, IQR: 39–50; 53.9% men). Incidence rates rose from the study period 2003 to 2007 compared with previous periods and remained stable thereafter, both in men and women. Hence, incidence per 100,000 per year was globally 11.0 (95% CI: 9.4–12.7) before 2003 and 22.9 (20.3–25.6) thereafter. In individuals aged 18–45 years, incidence rates were 5.4 (4.3–6.9) overall, 4.1 (2.7–6.0) in men, and 6.7 (4.9–9.0) in women, before 2003. After 2003, incidence rates rose to 12.8 (10.7–15.1) overall, 12.0 (9.2–15.4) in men, and 13.6 (10.6–17.0) in women. In this age group, the men/women IRR was 0.78 (95% CI: 0.62–1.26, <i>p</i> = 0.08), although sex differences decreased over time (IRR = 0.62; 95% CI: 0.36–1.02, <i>p</i> = 0.046 before 2003, vs. IRR = 0.88; 95% CI: 0.62–1.26, <i>p</i> = 0.48 after 2003). In individuals aged 45–55 years, incidence rates before 2003 were 47 (37–61) in men and 25 (17–35) in women (IRR = 1.90; 95% CI: 1.24–2.97, <i>p</i> &#x3c; 0.001), and they increased to 82 (67–100) in men and 46 (35–59) in women (IRR = 1.79; 95% CI: 1.29–2.49, <i>p</i> &#x3c; 0.001) after 2003. <b><i>Conclusions:</i></b> The incidence of ischemic stroke in young adults increased during the early 2000s and remained stable thereafter. These results highlight the priority need for dedicated prevention strategies for the young to reduce the burden of stroke.


2014 ◽  
Vol 121 (3) ◽  
pp. 527-535 ◽  
Author(s):  
Haley Gittleman ◽  
Quinn T. Ostrom ◽  
Paul D. Farah ◽  
Annie Ondracek ◽  
Yanwen Chen ◽  
...  

Object Pituitary tumors are abnormal growths that develop in the pituitary gland. The Central Brain Tumor Registry of the United States (CBTRUS) contains the largest aggregation of population-based data on the incidence of primary CNS tumors in the US. These data were used to determine the incidence of tumors of the pituitary and associated trends between 2004 and 2009. Methods Using incidence data from 49 population-based state cancer registries, 2004–2009, age-adjusted incidence rates per 100,000 population for pituitary tumors with ICD-O-3 (International Classification of Diseases for Oncology, Third Edition) histology codes 8040, 8140, 8146, 8246, 8260, 8270, 8271, 8272, 8280, 8281, 8290, 8300, 8310, 8323, 9492 (site C75.1 only), and 9582 were calculated overall and by patient sex, race, Hispanic ethnicity, and age at diagnosis. Corresponding annual percent change (APC) scores and 95% confidence intervals were also calculated using Joinpoint to characterize trends in incidence rates over time. Diagnostic confirmation by subregion of the US was also examined. Results The overall annual incidence rate increased from 2.52 (95% CI 2.46–2.58) in 2004 to 3.13 (95% CI 3.07–3.20) in 2009. Associated time trend yielded an APC of 4.25% (95% CI 2.91%–5.61%). When stratifying by patient sex, the annual incidence rate increased from 2.42 (95% CI 2.33–2.50) to 2.94 (95% CI 2.85–3.03) in men and 2.70 (95% CI 2.62–2.79) to 3.40 (95% CI 3.31–3.49) in women, with APCs of 4.35% (95% CI 3.21%–5.51%) and 4.34% (95% CI 2.23%–6.49%), respectively. When stratifying by race, the annual incidence rate increased from 2.31 (95% CI 2.25–2.37) to 2.81 (95% CI 2.74–2.88) in whites, 3.99 (95% CI 3.77–4.23) to 5.31 (95% CI 5.06–5.56) in blacks, 1.77 (95% CI 1.26–2.42) to 2.52 (95% CI 1.96–3.19) in American Indians or Alaska Natives, and 1.86 (95% CI 1.62–2.13) to 2.03 (95% CI 1.80–2.28) in Asians or Pacific Islanders, with APCs of 3.91% (95% CI 2.88%–4.95%), 5.25% (95% CI 3.19%–7.36%), 5.31% (95% CI –0.11% to 11.03%), and 2.40% (95% CI –3.20% to 8.31%), respectively. When stratifying by Hispanic ethnicity, the annual incidence rate increased from 2.46 (95% CI 2.40–2.52) to 3.03 (95% CI 2.97–3.10) in non-Hispanics and 3.12 (95% CI 2.91–3.34) to 4.01 (95% CI 3.80–4.24) in Hispanics, with APCs of 4.15% (95% CI 2.67%–5.65%) and 5.01% (95% CI 4.42%–5.60%), respectively. When stratifying by age at diagnosis, the incidence of pituitary tumor was highest for those 65–74 years old and lowest for those 15–24 years old, with corresponding overall age-adjusted incidence rates of 6.39 (95% CI 6.24–6.54) and 1.56 (95% CI 1.51–1.61), respectively. Conclusions In this large patient cohort, the incidence of pituitary tumors reported between 2004 and 2009 was found to increase. Possible explanations for this increase include changes in documentation, changes in the diagnosis and registration of these tumors, improved diagnostics, improved data collection, increased awareness of pituitary diseases among physicians and the public, longer life expectancies, and/or an actual increase in the incidence of these tumors in the US population.


2016 ◽  
Vol 43 (7) ◽  
pp. 1335-1339 ◽  
Author(s):  
Marie-Louise F. Hermansen ◽  
Jesper Lindhardsen ◽  
Christian Torp-Pedersen ◽  
Mikkel Faurschou ◽  
Søren Jacobsen

Objective.To determine the incidence of systemic lupus erythematosus (SLE) and SLE with concomitant or subsequent lupus nephritis (LN) in Denmark during 1995–2011, using data from the Danish National Patient Registry (NPR).Methods.To assess the incidence of SLE, we identified all persons aged ≥ 18 years in the NPR with at least 1 International Classification of Diseases, 10th ed (ICD-10) code of SLE and at least 365 days of followup under this diagnosis. Identification of LN cases was based on fulfillment of these criteria and ≥ 1 registration under an ICD-10 code of nephritis concomitantly with or after first SLE registration.Results.The overall annual incidence rate per 100,000 for SLE was 2.35 (95% CI 2.24–2.49); 0.69 (95% CI 0.60–0.78) for men and 3.96 (95% CI 3.75–4.17) for women. For LN, the mean annual incidence rate per 100,000 was estimated to be 0.45 (95% CI 0.38–0.53); 0.20 (95% CI 0.13–0.28) for men and 0.69 (95% CI 0.57–0.83) for women. The differences in SLE incidence rates between sexes decreased by age, and the incidence did not differ between men and women after the age of 60 years for LN. The estimated incidences showed no trends by calendar time. Estimated overall point prevalence (December 31, 2011) per 100,000 was 45.2 (95% CI 43.3–47.4) and 6.4 (95% CI 5.7–7.2) for SLE and LN, respectively.Conclusion.Our Danish population-based data showed a stable incidence of SLE and LN. As expected, we found higher incidence rates among women than among men, particularly in younger persons.


2017 ◽  
Vol 13 (5) ◽  
pp. 503-510 ◽  
Author(s):  
Raed A Joundi ◽  
Rosemary Martino ◽  
Gustavo Saposnik ◽  
Vasily Giannakeas ◽  
Jiming Fang ◽  
...  

Background Dysphagia screening is recommended after acute stroke to identify patients at risk of aspiration and implement appropriate care. However, little is known about the frequency and outcomes of patients undergoing dysphagia screening after intracerebral hemorrhage (ICH). Methods We used the Ontario Stroke Registry from 1 April 2010 to 31 March 2013 to identify patients hospitalized with acute stroke and to compare dysphagia screening rates in those with ICH and ischemic stroke. In patients with ICH we assessed predictors of receiving dysphagia screening, predictors of failing screening, and outcomes after failing screening. Results Among 1091 eligible patients with ICH, 354 (32.4%) patients did not have documented dysphagia screening. Patients with mild ICH were less likely to receive screening (40.4% of patients were omitted, adjusted odds ratio (aOR) 0.40, 95% confidence interval (CI) 0.26–0.63). Older age, greater stroke severity, speech deficits, lower initial level of consciousness, and admission to intensive care unit were predictive of failing the screening test. Failing screening was associated with poor outcomes, including pneumonia (aOR 5.3, 95% CI 2.36–11.88), severe disability (aOR 4.78, 95% CI 3.08–7.41), and 1-year mortality (adjusted hazard ratio 2.1, 95% CI 1.38–3.17). When compared to patients with ischemic stroke, patients with ICH were less likely to receive dysphagia screening (aOR 0.64, 95% CI 0.54–0.76) and more likely to fail screening (aOR 1.98, 95% 1.62–2.42). Conclusion One-third of patients with ICH did not have documented dysphagia screening, increasing to 40% in patients with mild clinical severity. Failing screening was associated with poor outcomes. Patients with ICH were less like to receive screening and twice as likely to fail compared to patients with ischemic stroke, and thus efforts should be made to include ICH patients in dysphagia screening protocols whenever possible.


Neurology ◽  
2018 ◽  
Vol 91 (20) ◽  
pp. e1909-e1917 ◽  
Author(s):  
Karoliina Aarnio ◽  
Jorge Rodríguez-Pardo ◽  
Bob Siegerink ◽  
Juliane Hardt ◽  
Jenna Broman ◽  
...  

ObjectiveWe aimed to investigate the proportion of young patients not returning to work (NRTW) at 1 year after ischemic stroke (IS) and during follow-up, and clinical factors associated with NRTW.MethodsPatients from the Helsinki Young Stroke Registry with an IS occurring in the years 1994–2007, who were at paid employment within 1 year before IS, and with NIH Stroke Scale score ≤15 points at hospital discharge, were included. Data on periods of payment came from the Finnish Centre for Pensions, and death data from Statistics Finland. Multivariate logistic regression analyses assessed factors associated with NRTW 1 year after IS, and lasagna plots visualized the proportion of patients returning to work over time.ResultsWe included a total of 769 patients, of whom 289 (37.6%) were not working at 1 year, 323 (42.0%) at 2 years, and 361 (46.9%) at 5 years from IS. When adjusted for age, sex, socioeconomic status, and NIH Stroke Scale score at admission, factors associated with NRTW at 1 year after IS were large anterior strokes, strokes caused by large artery atherosclerosis, high-risk sources of cardioembolism, and rare causes other than dissection compared with undetermined cause, moderate to severe aphasia vs no aphasia, mild and moderate to severe limb paresis vs no paresis, and moderate to severe visual field deficit vs no deficit.ConclusionsNRTW is a frequent adverse outcome after IS in young adults with mild to moderate IS. Clinical variables available during acute hospitalization may allow prediction of NRTW.


2019 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
K. M. Kurbonov ◽  
E. G. Simonova ◽  
N. N. Filatov

The aim of this work was to study modern manifestations of seasonal brucellosis among the population of the Republic of Tajikistan. The materials and methods: of the study were the official statistics, as well as the results of previously performed studies on the risk assessment of the incidence in population. A retrospective epidemiological analysis of annual incidence rate for the period from 1997 to 2016 was conducted, depending on the most significant social and environmental risk factors. Results. The article shows the impact on the annual incidence rate of socio-economic transformations, including the privatization of collective livestock farms, accompanied by the massive movement of farm animals to private ownership, the loss of practice in animal breeding, and changes in environmental and climatic conditions. Against the background of the intensification of sheep breeding, there is a tendency in seasonality smoothing and shifting the maximum levels of population incidence of brucellosis to the spring season. Conclusion. The modern features of seasonal manifestation of brucellosis infection in the Republic of Tajikistan make it necessary to apply a differentiated approach to planning and conducting preventive measures in various areas of the country.


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