National Hospital of Sri Lanka, Colombo 01000, Sri Lanka.
Ministry of Health, 385, Ven. Baddegama Wimalawansa Thero Mawatha, Colombo 01000, Sri Lanka.
J Stroke Cerebrovasc Dis. 2023 Oct;32(10):107269. doi: 10.1016/j.jstrokecerebrovasdis.2023.107269. Epub 2023 Aug 12.
Stroke registries are pivotal to the monitoring and improvement of the quality of stroke care. We report data from the initial phase of a nationally representative hospital-based stroke registry in Sri Lanka.
Based on an observational cohort design, all consecutive patients aged ≥18 years with a diagnosis of stroke or transient ischemic attack (TIA) presenting to six tertiary-care hospitals in the Western, Eastern, Southern, Northern and Central provinces of Sri Lanka within 14 days of onset were recruited.
During a period of 14 months, 5893 patients with a stroke/TIA (58.8% men; mean age 65.22 years, SD=13.28) were entered into the database; 69.8% (n=4111) had an ischaemic stroke (IS); 20.9% (n=1233) had a haemorrhagic stroke (HS); 7.2% (424) had a TIA; and 2.1% (125) had a venous stroke. While IS were more common among women (71.7% vs 68.4%; p=0.006), HS were more common among men (22.3% vs 19.0%; p=0.003). Hemiparesis (86.2% vs 83.2%; p=0.011), headache (29% vs 11.6%; p<0.001), seizures (5.9% vs 4.2%; p=0.013), sphincter dysfunction (11.8% vs 7.7%; p<0.001) and hypertension (72% vs 67.3%, p=0.002) were more common in HS while dysphasia (63.2% vs 50.0%; p<0.001), ataxia (9.6% vs 7.3%; p=0.014), sensory disturbances (10.8% vs 6.0%; p<0.001) and diabetes mellitus (37.9% vs 28.1%; p<0.001) were more common in IS. Thrombolysis was administered in only 2.1% while only 14.6% had access to stroke units. The mean door-to-needle time was 100.2 (SD=46.0) minutes. The hospital mortality rate was 8.3%. Recurrent strokes within three months were more common in HS than IS (3.2% vs 1.6%; p=0.007).
While stroke characteristics in Sri Lanka are similar to that of other populations, the rate of thrombolysis and access to stroke units are inadequate. The stroke registry provides useful data for the appraisal and improvement of stroke services.
中风登记处对于监测和改善中风护理质量至关重要。我们报告了斯里兰卡一项全国代表性的基于医院的中风登记处初始阶段的数据。
基于观察性队列设计，在发病后 14 天内，将来自斯里兰卡西部、东部、南部、北部和中部 6 家三级保健医院的所有年龄≥18 岁的连续诊断为中风或短暂性脑缺血发作（TIA）的患者纳入数据库。
在 14 个月的时间里，共有 5893 名中风/TIA 患者（58.8%为男性；平均年龄 65.22 岁，标准差=13.28）被纳入数据库；69.8%（n=4111）为缺血性中风（IS）；20.9%（n=1233）为出血性中风（HS）；7.2%（n=424）为 TIA；2.1%（n=125）为静脉性中风。虽然女性中 IS 更为常见（71.7%与 68.4%；p=0.006），但男性中 HS 更为常见（22.3%与 19.0%；p=0.003）。偏瘫（86.2%与 83.2%；p=0.011）、头痛（29%与 11.6%；p<0.001）、癫痫发作（5.9%与 4.2%；p=0.013）、括约肌功能障碍（11.8%与 7.7%；p<0.001）和高血压（72%与 67.3%；p=0.002）在 HS 中更为常见，而构音障碍（63.2%与 50.0%；p<0.001）、共济失调（9.6%与 7.3%；p=0.014）、感觉障碍（10.8%与 6.0%；p<0.001）和糖尿病（37.9%与 28.1%；p<0.001）在 IS 中更为常见。只有 2.1%的患者接受了溶栓治疗，只有 14.6%的患者能够进入中风病房。平均门到针时间为 100.2（SD=46.0）分钟。医院死亡率为 8.3%。HS 中三个月内复发中风的比例高于 IS（3.2%与 1.6%；p=0.007）。
虽然斯里兰卡的中风特征与其他人群相似，但溶栓治疗率和中风病房的利用率不足。中风登记处为评估和改善中风服务提供了有用的数据。
