阿根廷一项基于人群的研究中首次报告的卒中与短暂性脑缺血发作发病率和 30 天病死率。
First-Ever Stroke and Transient Ischemic Attack Incidence and 30-Day Case-Fatality Rates in a Population-Based Study in Argentina.
机构信息
From the INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina (M.C.B.); Hospital Santamarina, Tandil, Buenos Aires, Argentina (M.L.C., M.D.M., A.D., M.L.L., R.M., C.M., G.O., D.S., A.U.); Department of Clinical Neurological Sciences, London Health Sciences Centre, and London Heart & Brain Research Program, Western University, London, Ontario (P.M.R., L.A.S.); Ivey Business School, Western University, London, Ontario, Canada (L.E.C.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (G.A.R.); Duke University Medical Center, Duke Clinical Research Institute, Durham, NC (R.D.L.); Faculty of Health and Environmental Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand (V.L.F.); Sanatorio Tandil, Tandil, Buenos Aires, Argentina (B.B.G., D.M.); Argentinean Ministry of Health (D.F.); Nueva Clínica Chacabuco, Tandil, Buenos Aires, Argentina (F.F., P. Macarrone, P. Martínez, R.S.); Servicio de Neurología, Clínica Alemana, Centro de Neurociencias, Universidad del Desarrollo, Santiago, Chile and Departamento de Ciencias Neurológicas, Universidad de Chile (P.L.); Department of Neurology, Mayo Clinic, Rochester, MN (A.A.R.); Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada (G.S.); Department of Neurology, Rigshospitalet, Copenhagen, Denmark (T.T.); and Círculo Médico, Tandil, Buenos Aires, Argentina (D.H.L., C.A.V.).
出版信息
Stroke. 2016 Jun;47(6):1640-2. doi: 10.1161/STROKEAHA.116.013637. Epub 2016 May 5.
BACKGROUND AND PURPOSE
Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina.
METHODS
We prospectively identified all first-ever stroke and TIA cases from overlapping sources between January 5, 2013, and April 30, 2015, in Tandil, Argentina. We calculated crude and standardized incidence rates. We estimated 30-day case-fatality rates.
RESULTS
We identified 334 first-ever strokes and 108 TIAs. Age-standardized incidence rate per 100 000 for Segi's World population was 76.5 (95% confidence interval [CI], 67.8-85.9) for first-ever stroke and 25.1 (95% CI, 20.2-30.7) for first-ever TIA, 56.1 (95% CI, 48.8-64.2) for ischemic stroke, 13.5 (95% CI, 9.9-17.9) for intracerebral hemorrhage, and 4.9 (95% CI, 2.7-8.1) for subarachnoid hemorrhage. Stroke incidence was slightly higher for men (87.8; 95% CI, 74.6-102.6) than for women (73.2; 95% CI, 61.7-86.1) when standardized for the Argentinean population. Thirty-day case-fatality rate was 14.7% (95% CI, 10.8-19.5) for ischemic stroke, 24.1% (95% CI, 14.2-36.6) for intracerebral hemorrhage, and 1.9% (95% CI, 0.4-5.8) for TIA.
CONCLUSIONS
This study provides the first prospective population-based stroke and TIA incidence and case-fatality estimate in Argentina. First-ever stroke incidence was lower than that reported in previous Latin-American studies, but first-ever TIA incidence was higher. Thirty-day case-fatality rates were similar to those of other population-based Latin-American studies.
背景与目的
在中低收入的拉丁美洲国家，有关中风的流行病学数据十分匮乏。我们在阿根廷坦迪尔的一个基于人群的环境中调查了首次中风和短暂性脑缺血发作（TIA）的年发病率和 30 天病死率。
方法
我们前瞻性地确定了 2013 年 1 月 5 日至 2015 年 4 月 30 日重叠来源的所有首次中风和 TIA 病例。我们计算了粗发病率和标准化发病率。我们估计了 30 天病死率。
结果
我们共发现 334 例首发性中风和 108 例 TIA。Segi 世界人口年龄标准化发病率为每 100000 人 76.5（95%置信区间[CI]，67.8-85.9）的首发性中风和每 100000 人 25.1（95%CI，20.2-30.7）的首发性 TIA，缺血性中风为 56.1（95%CI，48.8-64.2），脑出血为 13.5（95%CI，9.9-17.9），蛛网膜下腔出血为 4.9（95%CI，2.7-8.1）。标准化后，男性中风发病率（87.8；95%CI，74.6-102.6）略高于女性（73.2；95%CI，61.7-86.1）。缺血性中风的 30 天病死率为 14.7%（95%CI，10.8-19.5），脑出血为 24.1%（95%CI，14.2-36.6），TIA 为 1.9%（95%CI，0.4-5.8）。
结论
本研究提供了阿根廷首次前瞻性基于人群的中风和 TIA 发病率和病死率的首个估计值。首次中风发病率低于之前拉丁美洲的研究报告，但首次 TIA 发病率更高。30 天病死率与其他拉丁美洲基于人群的研究相似。
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