智利伊基克市的卒中发病率、30d病死率以及预后:一项历时2年基于社区的前瞻性研究(PISCIS计划)

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Background: The epidemiology of stroke in Latin- American populations and va riation of subtypes between communities are unclear. Our aim was to ascertain pr ospectively the incidence of first- ever stroke in the predominantly Hispanic- Mestizo population of Iquique, a city in the northern desert region of Chile. M ethods: We prospectively identified all possible cases of stroke and transient i schaemic attacks between July 1, 2000, and June 30, 2002, from several overlappi ng sources. Patients were rapidly assessed by two field neurologists. Standard d efinitions for incident cases, stroke, transient ischaemic attack, pathological type, and infarction subtype were used. All cases identified were adjudicated by at least two stroke neurologists and followed up at 6 months. Incidence rates o f first- ever strokes were calculated from the population of Iquique (214 526) according to the national census of 2002. Findings: Of 380 cases of stroke ident ified, 292 were incident. CT scans were done in 267 (91% ) patients and the mea n time to scan was 2.2 days. The hospital admission rate was 71% (207/292). Th e overall age- adjusted incidence rate of first- ever stroke was 140.1 per 100 000 (95% CI 124.0- 156.2). The incidence rates per 100 000 according to path ological type were: infarcts 87.3, intracerebral haemorrhage 27.6, and subarachn oid haemorrhage 6.2. The 30 day and 6- month case- fatality rates were 23.3% and 33.0% , respectively. Interpretation: Our results show incidence rates of stroke similar to those reported in other community studies. Although the propor tion of intracerebral haemorrhages was higher than reported in previous studies, the overall incidence was not, which could indicate a slightly lower incidence of ischaemic strokes in this population than in other countries. The prognosis w as similar to that found in other population- based studies. Background: The epidemiology of stroke in Latin- American populations and va riation of subtypes between communities are unclear. Our aim was to ascertain pr ospectively the incidence of first-ever stroke in the predominantly Hispanic-Mestizo population of Iquique, a city in the northern desert region of Chile. M ethods: We prospectively identified all possible cases of stroke and transient i schaemic attacks between July 1, 2000, and June 30, 2002, from several overlappi ng sources. Patients were rapidly assessed by two field neurologists. Standard d efinitions for incident cases, stroke, transient ischaemic attack, pathological type, and infarction subtype were used. All cases identified were adjudicated by at least two stroke neurologists and subsequently up at 6 months. Incidence rates of first-ever strokes were calculated from the population. of Iquique (214 526) according to the national census of 2002. Findings: Of 380 cases of stroke ident ified, 292 were incident. CT scans were done in 267 (91%) patients and the mea n time to scan was 2.2 days. The hospital admission rate was 71% (207/292). Th e overall age- adjusted incidence rate of first- ever stroke was 140.1 per 100 000 (95% CI 124.0- 156.2). The incidence rates per 100 000 according to pathological type were: infarcts 87.3, intracerebral haemorrhage 27.6, and subarachnoid haemorrhage 6.2. The 30 day and 6- month case-fatality rates were 23.3% and Interpretation: Our results show incidence of stroke similar to those reported in other community studies. However, the findings of the incidence of intracerebral haemorrhages was higher than reported in previous studies, the the incidence of ancestor not, which could indicate a slightly lower incidence of ischaemic strokes in this population than in other countries. The prognosis w as similar to that found in other population- based studies.
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