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London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 627 533 Epidemiology of stroke STROKE IN BANJALUKA REGION (REPUBLIC OF SRPSKA – BiH) S. Miljkovic1, Z. Vujkovic2, D. Racic3, V. Djajic4, S. Crncevic5, M. Djukanovic6 Clinical center Banjaluka, Banjaluka, BOSNIA-HERZEGOVINA1, Clinical center Banjaluka, Banjaluka, BOSNIA-HERZEGOVINA2, Clinical center Banjaluka, Banjaluka, BOSNIA-HER-ZEGOVINA3, Clinical center Banjaluka, Banjaluka, BOSNIA-HERZEGOVINA4, Clinical center Banjaluka, Banjaluka, BOSNIA-HERZEGOVINA5, Clinical center Banjaluka, Banjaluka, BOS-NIA- HERZEGOVINA6 Stroke is sudden death of brain cells in a localized area due to inadequate blood low, which is the re-sult of thrombosis, embolism or hemorrhage, and one of the three most common and serious diseas-es with high medical, emotional and socioeconomic consequences to the elderly, their families and health care system. During the 2012 year we have made prospective study to identify total number of stroke people in Banjaluka region (Republic of Srpska capital city), with above 250000 residents. We also investigate the most common risk factors and outcome of our patients. For this purpose we first created stroke register for our center where we enetered demographic data, risk factors, type of stroke, diagnostic methods, NIHSS score, Rankin score on admission and release. Results: We registered 1533 stroke patients in one year period of study (2012), 790 male (51,53%) i 743 female (48,47%). There was 82,25% ischemic stroke and 17,75% hemorrhagic. Letality was 37, 44 %; 33,92% for male and 41,18% for female, and 26,24% for ishemic stroke and 43,75% for hem-orrhagic stroke. The most common risk factors were hypercholesterolaemia (84,08% of our patients had a high level of cholesterol) than hypertension 74,88%, hypertrigliceridaemia 30,47%, smoking 29,49%, atrial fi-brilation 24,85%, alcohol consumption 21,86%. We also measured outcome of survived stroke patients through Rankin scale and we found 20,83% in Rankin 0, 8,48% in Rankin 2, 15,07% in Rankin 2, 16,55 in Rankin 3, 21,05% in Rankin 4 and 18,02 in Rankin 5. This study has showed that stroke is one of the biggest health problem in our community with high rate of letality and high degree od disability also. Analysis of risk factors telling us that we should work more intensively to reduce them (first to reduce hypertension and than to change eating habits and increase physical activity in order to reduce level of holesterol and finaly encourage people to stop smoking). 534 Epidemiology of stroke The Age of Uncertainty: Identifying differences in best practice indicators between young and older patients with stroke in the Canadian National Stroke Audit R. Swartz1, T.L. Green2, J. Fang3, M. Lindsay4 Sunnybrook Health Sciences Cente, University of Toronto, Toronto, CANADA1, University of Calgary, Calgary, CANADA2, Institute for Clinical Evaluative Sciences, Toronto, CANADA3, Cana-dian Stroke Network, University of Toronto, Toronto, CANADA4 Background: In young adults with neurological symptoms, especially those from 18 to 45 years, stroke is often not an early diagnostic consideration. The diagnosis may be missed, or treatments de-layed. Conversely, some younger patients may be treated more aggressively than older patients. This project investigates differences in stroke best practices between younger and older stroke patients. Methods: A sub-analysis of the Canadian Stroke Audit data was performed. Dataset included 39,690 cases for the 2008-09 fiscal year. Descriptive and inferential analysis were conducted to look at se-lected best practice guideline process of care and compare patterns between stroke patients aged 18 to 44 years and 45 years and older. Results: There was no difference in the proportion of patients receiving a CT-scan within 25 min-utes or 24 hours. The proportion of patients receiving tPA was similar, but more young patients re-ceived IA tPA (18.6% vs. 4.1%). Door-to-needle times were not different, but more young patients were treated after 4 hours. More young patients were admitted to a stroke unit (29.5% vs. 20%, p<0.0001). There was no difference in length of stay, or in patients discharged on antithrombotics; however, fewer younger patients were discharged on lipid lowering and anti-hypertensive treat-ments. Discharge destinations differed significantly: more young patients went home, but fewer went to rehabilitation or long-term/complex care. Conclusions: There does not appear to be a systemic bias suggesting delays in diagnosis or treat-ment of hyperacute stroke in young patients. Younger patients are more likely to receive aggressive treatments including tPA outside the time window, intra-arterial tPA and stroke unit care, but may be less likely to receive risk modifying treatments in hospital (swallowing screening) or on discharge (lipid or hypertensive treatments). Stroke services must be adaptable to address unique needs and challenges of this stroke population.


Karger_ESC London_2013
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