Dataset Information

Acute Ischemic Stroke Hospital Admissions, Treatment, and Outcomes in Poland in 2009-2013.

ABSTRACT:

Introduction

Ischemic stroke (IS) still constitutes a serious problem for public health worldwide. The data on its burden in Poland before 2009 is limited and came only from a few metropolitan areas.

The aims of the study were

To assess temporal trends in the hospital admissions, treatment, and outcomes of IS in Poland in 2009-2013, to identify risk factors for IS mortality and to compare the results with other countries.

Methods

The data from the Polish Stroke Registry were analyzed. The data concerned all subjects hospitalized due to IS (classified according to the ICD10 classification as I63.0-I63.9) as primary diagnosis in Poland in 2009-2013. Temporal trends in treatment and outcome were analyzed. Hospital admissions rates as well as case fatality and 12-month mortality rates were calculated.

Results

Altogether, 360,556 patients (47.5% of males) were hospitalized due to IS in Poland in 2009-2013. The median of age was 75?years, IQR 18 (Women 78, IQR 14 vs. Men 70, IQR 17; p?p for trend?p for trend?p for trend <0.001).

Conclusion

Since 2009, Poland has had national epidemiological data on the hospital admissions, treatment, and outcomes in IS. The data indicate a slow improvement of in-hospital survival and suggest the need for better stroke prevention and further dissemination of reperfusion therapy.

SUBMITTER: Chwojnicki K

PROVIDER: S-EPMC5858531 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Acute Ischemic Stroke Hospital Admissions, Treatment, and Outcomes in Poland in 2009-2013.

Chwojnicki Kamil K Ryglewicz Danuta D Wojtyniak Bogdan B Zagożdżon Paweł P Członkowska Anna A Jędrzejczyk Tadeusz T Karaszewski Bartosz B Kozera Grzegorz G Gierlotka Marek M Ezzati Majid M Zdrojewski Tomasz T

Frontiers in neurology 20180313

<h4>Introduction</h4>Ischemic stroke (IS) still constitutes a serious problem for public health worldwide. The data on its burden in Poland before 2009 is limited and came only from a few metropolitan areas.<h4>The aims of the study were</h4>To assess temporal trends in the hospital admissions, treatment, and outcomes of IS in Poland in 2009-2013, to identify risk factors for IS mortality and to compare the results with other countries.<h4>Methods</h4>The data from the Polish Stroke Registry wer ...[more]

PMID: 29593634

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Project description:Background: Intravenous thrombolysis with alteplase benefits eligible patients with acute ischemic stroke. However, in some countries such as China, alteplase may be too expensive for low-income patients, and also for regions with low economic development. Urokinase is much less expensive than alteplase. This study aimed to assess the outcomes and treatment complications of urokinase in acute ischemic stroke patients, which are poorly understood. Methods: This multicenter retrospective study included acute ischemic stroke patients who received intravenous urokinase or alteplase from January 2014 to January 2018 at 21 centers in China. Outcomes and treatment complications were analyzed by univariate and multivariate analyses. Results: Among the 618 patients included in this study, 489 were treated with urokinase and 129 were treated with alteplase. Functional independence, no/minimal disability, mortality, intracranial hemorrhage (ICH), and symptomatic ICH did not significantly differ between the urokinase and alteplase groups in the univariate and multivariate analyses. However, the patients who received alteplase had a lower odds ratio (OR) of extracranial bleeding in the univariate analysis and a lower adjusted OR (aOR) in the multivariate analysis than the patients who received urokinase (OR = 0.410 [95% CI, 0.172-0.977], p = 0.038; aOR = 0.350 [95% CI, 0.144-0.854], p = 0.021). Furthermore, in patients treated with urokinase, the patients who received high-dose urokinase had a higher OR of extracranial bleeding in the univariate analysis and a higher aOR of extracranial bleeding in the multivariate analysis than patients who received low-dose urokinase (OR = 3.046 [95% CI, 1.696-5.470], p < 0.001; aOR = 3.074 [95% CI, 1.627-5.807], p = 0.001). Moreover, patients who received low-dose urokinase had similar outcomes and complications compared to patients treated with alteplase. Conclusions: Patients treated with urokinase had similar outcomes but a higher risk of extracranial bleeding compared to patients treated with alteplase. The risk of extracranial bleeding was higher in the patients treated with high-dose urokinase than in the patients treated with low-dose urokinase. Patients who received low-dose urokinase had similar outcomes and complications compared to patients treated with alteplase. In countries such as China where some acute ischemic stroke patients cannot afford alteplase, urokinase may be a good alternative to alteplase for intravenous thrombolysis.

Dataset Information

Acute Ischemic Stroke Hospital Admissions, Treatment, and Outcomes in Poland in 2009-2013.

Introduction

The aims of the study were

Methods

Results

Conclusion

Publications

Acute Ischemic Stroke Hospital Admissions, Treatment, and Outcomes in Poland in 2009-2013.

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