scholarly journals Long-Term Trends in Stroke Management and Burden Among Low-Income Women in a Rural Area From China (1992–2019): A Prospective Population-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaobing Tian ◽  
Jie Liu ◽  
Changshen Yu ◽  
Yabing Hou ◽  
Changqing Zhan ◽  
...  
Keyword(s):  
Low Income ◽  
Chinese Women ◽  
Case Fatality ◽  
Population Based ◽  
Stroke Recurrence ◽  
Stroke Management ◽  
Recurrence Rates ◽  
Long Term Trends ◽  
Low Income Women

Although an increasing number of studies are considering sex-related differences in stroke burden, the trends in stroke burden and management among women in China, especially among low-income women, remain unclear. This study evaluated the long-term trends in stroke management and burden among low-income Chinese women during the period between 1992 and 2019. Stroke burden was assessed using the age-adjusted incidence of first-ever stroke, whereas stroke management was assessed using the rates of neuroimaging diagnoses, hospitalizations, case fatalities, and stroke recurrence. Stroke burden and management were analyzed during four study periods: 1992–1998, 1999–2004, 2005–2012, and 2013–2019. During the 193,385 person-years of surveillance in this study, 597 female stroke patients were identified. The stroke incidences per 100,000 person-years were 88.1 cases during 1992–1998, 145.4 cases during 1999–2004, 264.3 cases during 2005–2012, and 309.8 cases during 2013–2019 (P < 0.001). Between 1992 and 2019, the incidence of stroke significantly increased (6.4% annually) as did the incidence of ischemic stroke (7.8% annually; both, P < 0.001). The rates of neuroimaging diagnoses and hospitalizations significantly increased during the four periods, while the case fatality rates and 1-year recurrence rates decreased significantly for both overall strokes and ischemic strokes, especially among patients ≥45 years old (all, P < 0.001). Among low-income women in China, stroke management is gradually improving, despite the increasing stroke burden. Thus, improved healthcare coverage is needed to further reduce the stroke burden among low-income Chinese women.

scholarly journals Twenty-Year Time Trends in Long-Term Case-Fatality and Recurrence Rates After Ischemic Stroke Stratified by Etiology

Stroke ◽  
2020 ◽  
Vol 51 (9) ◽  
pp. 2778-2785 ◽  
Author(s):  
Viktoria Rücker ◽  
Peter U. Heuschmann ◽  
Martin O’Flaherty ◽  
Michael Weingärtner ◽  
Manuela Hess ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Time Trends ◽  
Cox Regression ◽  
Case Fatality ◽  
Population Based ◽  
Artery Occlusion ◽  
Recurrence Rates ◽  
Term Survival ◽  
Small Artery Occlusion

Background and Purpose: Data on long-term survival and recurrence after stroke are lacking. We investigated time trends in ischemic stroke case-fatality and recurrence rates over 20-years stratified by etiological subtype according to the Trial of ORG 10172 in Acute Stroke Treatment classification within a population-based stroke register in Germany. Methods: Data was collected within the Erlangen Stroke Project, a prospective, population-based stroke register covering a source population of 105 164 inhabitants (2010). Case fatality and recurrence rates for 3 months, 1 year, and 5 years were estimated with Kaplan-Meier estimates. Sex-specific time trends for case-fatality and recurrence rates were estimated with Cox regression. We adjusted for age, sex, and year of event and stratified for etiological subtypes. A sensitivity analysis with competing risk analysis for time trends in recurrence were performed. Results: Between 1996 and 2015, 3346 patients with first ischemic stroke were included; age-standardized incidence per 100 000 was 75.8 in women and 131.6 in men (2015). Overall, 5-year survival probabilities were 50.4% (95% CI, 47.9–53.1) in women and 59.2% (95% CI, 56.4–62.0) in men; 5-year survival was highest in patients with first stroke due to small-artery occlusion (women, 71.8% [95% CI, 67.1–76.9]; men, 75.9% [95% CI, 71.3–80.9]) and lowest in cardioembolic stroke (women, 35.7% [95% CI, 31.0–41.1]; men, 47.8% [95% CI, 42.2–54.3]). Five-year recurrence rates were 20.1% (95% CI, 17.5–22.6) in women and 20.1% (95% CI, 17.5–22.7) in men; 5-year recurrence rate was lowest in women in stroke due to small artery occlusion 16.0% (95% CI, 11.7–20.1) and in men in large-artery atherosclerosis 16.6% (95% CI, 8.7–23.9); highest risk of recurrence was observed in undefined strokes (women, 22.3% [95% CI, 17.8–26.6]; men, 21.4% [95% CI, 16.7–25.9]). Cox regression revealed improvements in case-fatality rates over time with differences in stroke causes. No time trends in recurrence rates were observed. Conclusions: Long-term survival and recurrence varied substantially by first stroke cause. Survival probabilities improved over the past 2 decades; no major trends in stroke recurrence rates were observed.

Long-term trends in the incidence and relative survival of pancreatic cancer in Canada: A population-based study

Pancreatology ◽  
2016 ◽  
Vol 16 (2) ◽  
pp. 259-265 ◽  
Author(s):  
Gileh-Gol Akhtar-Danesh ◽  
Christian Finley ◽  
Noori Akhtar-Danesh
Keyword(s):  
Pancreatic Cancer ◽  
Relative Survival ◽  
Population Based ◽  
Population Based Study ◽  
Long Term Trends

scholarly journals The Impact of Pre- and Post-Stroke Statin Use on Stroke Severity and Long-Term Outcomes: A Population-Based Cohort Study

2019 ◽  
Vol 47 (5-6) ◽  
pp. 260-267 ◽  
Author(s):  
Clare Flach ◽  
Maria Elstad ◽  
Walter Muruet ◽  
Charles D.A. Wolfe ◽  
Anthony G. Rudd ◽  
...  
Keyword(s):  
Population Based ◽  
Stroke Recurrence ◽  
Stroke Severity ◽  
Stroke Incidence ◽  
Post Stroke ◽  
Improvement Programs ◽  
The Impact ◽  
The Relationship ◽  
Statin Use

Background: The benefit of statins on stroke incidence is well known. However, data on the relationship between pre- and post-stroke statin use, recurrence, and survival outcomes are limited. We aim to investigate the short- and long-term relationships between statin prescription, stroke recurrence, and survival in patients with first-ever ischemic stroke. Methods: Data were collected from the population-based South London Stroke Register for the years 1995–2015. Patients were assessed at the time of first ever stroke, 3 months, and annually thereafter. Data on vascular risk factors, treatments prescribed, sociodemographic characteristics, stroke subtype, survival, and stroke recurrence were collected. Cox proportional hazard analyses were used to assess the relationship of statin prescriptions pre- and post-stroke on stroke severity, long-term recurrence and survival. Results: Patients prescribed statins both pre- and post-stroke showed a 24% reduction in mortality (adjusted Hazard Ratio [aHR] 0.76, 0.60–0.97), those who were prescribed statins pre-stroke and then stopped post-stroke showed greater risk of mortality (aHR 1.85, 1.10–3.12) and stroke recurrence (aHR 3.25, 1.35–7.84) compared to those that were not prescribed statins at any time. No associations were observed between pre-stroke statin and severity of the initial stroke overall, though a protective effect against moderate/severe stroke (Glasgow Coma Scale ≤12) was observed in those aged 75+ years (aOR 0.70, 0.52–0.95). Conclusions: Statins play a significant role in improving the survival rates after a stroke. Adherence to the National Guidelines that promote statin treatment, primary and secondary prevention of stroke should be monitored and a focus for quality improvement programs.

Reducing the Digital Divide for Low-income Women With Breast Cancer: A Feasibility Study of a Population-Based Intervention

2005 ◽  
Vol 10 (sup1) ◽  
pp. 173-193 ◽  
Author(s):  
David H. Gustafson ◽  
Fiona M. McTavish ◽  
William Stengle ◽  
Denise Ballard ◽  
Ellen Jones ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Digital Divide ◽  
Feasibility Study ◽  
Low Income ◽  
Population Based ◽  
Low Income Women

scholarly journals Antihypertensive treatment should be commenced in hospital after stroke: Pro

2016 ◽  
Vol 12 (2) ◽  
pp. 121-122 ◽  
Author(s):  
Timothy Kleinig
Keyword(s):  
Antihypertensive Therapy ◽  
Strong Evidence ◽  
Antihypertensive Treatment ◽  
Eligible Patient ◽  
Stroke Recurrence ◽  
Recurrence Rates ◽  
Therapy Guidelines ◽  
Robust Evidence

The most important intervention to lower stroke recurrence rates is to ensure that every eligible patient adheres to antihypertensive therapy guidelines. Although there is no strong evidence that acute in-hospital antihypertensive treatment is either beneficial or harmful, there is robust evidence that long-term adherence is promoted by antihypertensive prescription in-hospital or at discharge.

scholarly journals Assessing the validity of a food frequency questionnaire among low-income women in São Paulo, southeastern Brazil

2010 ◽  
Vol 26 (11) ◽  
pp. 2059-2067 ◽  
Author(s):  
Marly Augusto Cardoso ◽  
Luciana Yuki Tomita ◽  
Elaine Cristina Laguna
Keyword(s):  
Low Income ◽  
Food Frequency Questionnaire ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Sao Paulo ◽  
Southeastern Brazil ◽  
São Paulo ◽  
Food Frequency ◽  
Low Income Women

This study describes the validity of a food frequency questionnaire (FFQ) in 93 low-income women (20-65 years), participating in a case-control study in São Paulo, Brazil. Two FFQ (FFQ1 and FFQ2, 12 months apart) and three 24-hour dietary recalls (24hR) were conducted between 2003 and 2004 to estimate dietary intake during the past year. The Pearson correlation coefficients (crude, energy-adjusted and de-attenuated) were used for comparisons between FFQ and 24hR. The agreement between the methods was further examined by the Bland-Altman analysis. For the assessment of long-term reliability, the energy-adjusted intra-class correlation coefficients were mostly around 0.40, but higher for vitamin A and folate (0.50-0.56). Energy-adjusted, attenuation-corrected Pearson validity correlations between FFQ and DR ranged from 0.30-0.54 for macronutrients to 0.20-0.48 for micronutrients, with higher value for calcium (0.75). There were small proportions of grossly misclassified nutrient intakes, while Bland-Altman plots indicated that the FFQ is accurate in assessing nutrient intake at a group level.

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