Department of Neurology, Harborview Medical Center, Room 3EH70, 325 Ninth Avenue, Seattle, WA 98104, USA.
BMC Neurol. 2012 Dec 3;12:150. doi: 10.1186/1471-2377-12-150.
As low and middle-income countries such as Vietnam experience the health transition from infectious to chronic diseases, the morbidity and mortality from stroke will rise. In line with the recommendation of the Institute of Medicine's report on "Promoting Cardiovascular Health in the Developing World" to "improve local data", we sought to investigate patient characteristics and clinical predictors of mortality among stroke inpatients at Da Nang Hospital in Vietnam.
A stroke registry was developed and implemented at Da Nang Hospital utilizing the World Health Organization's Stroke STEPS instrument for data collection.
754 patients were hospitalized for stroke from March 2010 through February 2011 and admitted to either the intensive care unit or cardiology ward. Mean age was 65 years, and 39% were female. Nearly 50% of strokes were hemorrhagic. At 28-day follow-up, 51.0% of patients with hemorrhagic stroke died whereas 20.3% of patients with ischemic stroke died. A number of factors were independently associated with 28-day mortality; the two strongest independent predictors were depressed level of consciousness on presentation and hemorrhagic stroke type. While virtually all patients completed a CT during the admission, evidence-based processes of care such as anti-thrombotic therapy and carotid ultrasound for ischemic stroke patients were underutilized.
This cohort study highlights the high mortality due in part to the large proportion of hemorrhagic strokes in Vietnam. Lack of hypertension awareness and standards of care exacerbated clinical outcomes. Numerous opportunities for simple, inexpensive interventions to improve outcomes or reduce recurrent stroke have been identified.
随着越南等中低收入国家经历从传染病到慢性病的健康转型，中风的发病率和死亡率将会上升。为了响应美国国家医学院的报告《在发展中国家促进心血管健康》中“改善当地数据”的建议，我们旨在研究越南岘港医院中风住院患者的特征和临床死亡预测因素。
在岘港医院利用世界卫生组织中风 STEPS 工具开发并实施了中风登记，以收集数据。
2010 年 3 月至 2011 年 2 月期间，共有 754 名中风患者住院，入住重症监护病房或心脏病科病房。平均年龄为 65 岁，39%为女性。近 50%的中风为出血性。28 天随访时，51.0%的出血性中风患者死亡，而 20.3%的缺血性中风患者死亡。一些因素与 28 天死亡率独立相关；两个最强的独立预测因素是入院时意识水平下降和出血性中风类型。虽然几乎所有患者在入院期间都完成了 CT 检查，但缺血性中风患者的抗血栓治疗和颈动脉超声等循证护理过程并未得到充分利用。
本队列研究强调了高死亡率，部分原因是越南出血性中风的比例较高。缺乏高血压意识和护理标准加剧了临床结局。已经确定了许多通过简单、廉价的干预措施来改善预后或减少中风复发的机会。
