London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 621 521 Epidemiology of stroke Behavioral factors rather than risk diseases may be responsible for younger age at stroke on-set in socioeconomically deprived regions within one city: the Budapest Districts 8-12 Project D. Bereczki1, I. Vastagh2, A. Kéri3, A. Majoros4, K.L. Kovács5, A. Ajtay6, Z. Laki7, B. Gunda8, K. Erdei9, L. Lenti10, Z. Dános11, A. Folyovich12 Department of Neurology, Semmelweis University, Budapest, HUNGARY1, Department of Neu-rology, Semmelweis University, Budapest, HUNGARY2, Department of Neurology, Semmelweis University, Budapest, HUNGARY3, Department of Neurology and Stroke, Szent János Hospital, Budapest, HUNGARY4, Department of Neurology, Semmelweis University, Budapest, HUNGA-RY5, Department of Neurology, Semmelweis University, Budapest, HUNGARY6, Department of Neurology and Stroke, Szent János Hospital, Budapest, HUNGARY7, Department of Neurology, Semmelweis University, Budapest, HUNGARY8, Department of Neurology and Stroke, Szent János Hospital, Budapest, HUNGARY9, Department of Neurology, Semmelweis University, Budapest, HUNGARY10, Department of Neu-rology and Stroke, Szent János Hospital, Budapest, HUNGARY11, Department of Neurology and Stroke, Szent János Hospital, Budapest, HUNGARY12 Background: poverty is known to be associated with younger age at stroke onset and higher rate of intracerebral hemorrhage. The reasons for this observation is not clear, especially in countries with universal healthcare systems where access to healthcare theoretically does not depend on income. In the current analysis of the Budapest Districts 8-12 Project we compare risk factor distribution in stroke patients of a wealthy and a poor neighborhood of one city. Methods: based on hospital discharge reports for reimbursement to the National Health Insurance Fund, the provider of universal healthcare access for the population of Hungary, we identified all patients hospitalized for stroke in year 2007 who had their permanent residence by postal code in ei-ther District 8 (ranking last in income of the 23 Budapest districts) or District 12 (ranking 2nd). The GP of the patients were identified by the NHIF database, and an anonymized database was estab-lished. The GPs were interviewed and were asked to fill in a questionnaire keeping the anonymity of the patients. Risk factor distribution was analyzed based on these forms. Results: Intensity of primary care (inhabitants per GP) was similar in the 2 the districts. Except for diabetes (p=0.04), there was no difference between stroke patients of the 2 districts in the prevalence of stroke risk diseases (hypertension, atrial fibrillation, other heart disease, peripheral ar-terial disease and previous stroke or TIA). In contrast, smoking, heavy smoking, alcohol dependence and non- or nonregularly treated hypertension were significantly more frequent among stroke pa-tients of the poor neighborhood (p<0.01 for all). Conclusion: equal availability does not mean equal use and efficacy of primary healthcare in poor and wealthy regions. Less efficient hypertension care associated with higher prevalence of life style stroke risk factors may at least partly explain the younger age at stroke onset in less wealthy districts even within one city. 522 Epidemiology of stroke The proportion and characteristics of non stroke admission to an acute stroke unit. P. I. ELOFUKE1, R. CLARKE2, D. HUNTER3, O. Dziewieck4, J. REID5 ABERDEEN ROYAL INFIRMARY, ABERDEEN, UNITED KINGDOM1, ABERDEEN ROY-AL INFIRMARY, ABERDEEN, UNITED KINGDOM2, UNIVERSITY OF ABERDEEN, AB-ERDEEN, UNITED KINGDOM3, ABERDEEN ROYAL INFIRMARY, ABERDEEN, UNITED KINGDOM4, ABERDEEN ROYAL INFIRMARY, ABERDEEN, UNITED KINGDOM5 BACKGROUND Non stroke (NS) diagnoses represent a significant proportion of suspected strokes admitted to acute stroke units. The need to rapidly assess patients with suspected acute ischemic stroke to identify those eligible for thrombolysis may increase the rate of NS diagnosis. This study aimed to assess rate and characteristics of NS diagnosis in a tertiary care acute stroke unit and the implication for stroke training. METHOD The discharge database of the acute stroke unit, Aberdeen Royal Infirmary was retrospectively in-terrogated for data on all admissions between July 2011 and August 2012. Demographics, length of hospital stay, final diagnosis, hypertension, cholesterol, AF, smoking status, discharge modified rankin and destination were recorded. Patients with uncertain diagnosis were classified as non stroke. RESULTS 81/637 NS admissions were identified (13%). Compared with stroke/TIA group, NS patients were significantly younger (61yrs Vs. 72yrs, p<0.0001); had shorter hospital length of stay (3 Vs. 9 days, p<0.0001);less disabled (discharge mRS 0 Vs. 2 p<0.0001); more likely to be discharged home (90% Vs 38% P<0.0001) and are less likely to be in AF (7.8% Vs. 24.7% p<0.001). There was no difference in smoking status, serum cholesterol and blood pressure. 3/81 (3.7%) patients with NS diagnosis received thrombolysis with no adverse consequences. Common NS diagnoses were migraine (25%), functional neurological disorder (18.5%), seizure (11%), brain tumours (7.4%) and syncope (3.4%). The diagnosis was uncertain in 10/81 cases (12%). 55% of NS diagnoses are neurological conditions. CONCLUSION Non stroke diagnosis made up 13% of suspected stroke admitted to the acute stroke unit. They are younger and have better discharge outcome. Neurological conditions make up over a half the di-agnoses mimicking stroke. Experience in neurology should be proportionately represented in the stroke training curriculum.
Karger_ESC London_2013
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