Mihálka L, Fekete I, Csépány T, Csiba L, Bereczki D
Department of Neurology, University Medical School of Debrecen, Hungary.
Eur J Epidemiol. 1999 May;15(5):461-6. doi: 10.1023/a:1007597718791.
Stroke mortality is extremely high in Central-Eastern European countries. We report basic characteristics of a stroke unit in Eastern Hungary, including age and sex distribution; the proportion of transient ischemic attacks (TIA), ischemic and hemorrhagic strokes; case fatality; application of diagnostic methods; and length of stay for all patients treated with acute cerebrovascular disease over a 12-month period. Records of all patients with acute cerebrovascular disease (n = 522) discharged in 1995 from a stroke unit with a well defined catchment area of 220,000 inhabitants in Eastern Hungary were retrospectively analyzed. Case fatality was 18.6% for all patients and 21.1% after excluding cases with TIA. Computer tomography, duplex carotid ultrasound, cerebrospinal fluid examination and electroencephalography were performed in 79%, 77%, 7% and 2% of the patients, respectively. The database of the university hospital with the same catchment area was electronically searched for patients who were discharged with the diagnosis of stroke from the three departments of internal medicine. Stroke mortality data of the catchment area based on death certificates was obtained from the Central Statistical Bureau. Two hundred twenty-eight stroke deaths were reported in the catchment area in 1995. In the same period 97 stroke deaths occurred at the stroke unit and 76 at the departments of internal medicine. If we aim to treat all patients with acute stroke at the stroke unit, with the present stroke incidence and duration of hospital stay the current capacity of the stroke unit (1 bed per 10.000 inhabitants) should be doubled.
中东欧国家的卒中死亡率极高。我们报告了匈牙利东部一家卒中单元的基本特征,包括年龄和性别分布;短暂性脑缺血发作(TIA)、缺血性卒中和出血性卒中的比例;病死率;诊断方法的应用情况;以及在12个月期间所有急性脑血管疾病患者的住院时间。回顾性分析了1995年从匈牙利东部一个卒中单元出院的所有急性脑血管疾病患者(n = 522)的记录,该卒中单元的明确服务区域为22万居民。所有患者的病死率为18.6%,排除TIA病例后的病死率为21.1%。分别有79%、77%、7%和2%的患者接受了计算机断层扫描、双功能颈动脉超声、脑脊液检查和脑电图检查。通过电子检索同一服务区域大学医院的数据库,查找从三个内科科室出院诊断为卒中的患者。基于死亡证明的服务区域卒中死亡率数据来自中央统计局。1995年服务区域报告了228例卒中死亡病例。同期,卒中单元发生97例卒中死亡,内科科室发生76例。如果我们旨在卒中单元治疗所有急性卒中患者,按照目前的卒中发病率和住院时间,卒中单元目前的容量(每10000居民1张床位)应翻倍。