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Stroke in the Middle-East and North Africa: A 2-year prospective observational study of stroke characteristics in the region—Results from the Safe Implementation of Treatments in Stroke (SITS)–Middle-East and North African (MENA)
International Journal of Stroke ( IF 6.3 ) Pub Date : 2019-03-12 , DOI: 10.1177/1747493019830331
Suhail Al Rukn 1 , Michael V Mazya 2, 3 , Faycal Hentati 4 , Samia Ben Sassi 4 , Fatma Nabli 4 , Zakharia Said 4 , Belahsen Faouzi 5 , Husnain Hashim 1 , Foad Abd-Allah 6 , Benhan Mansouri 7 , Selma Kesraoui 8 , Souheil Gebeily 9 , Husen Abdulrahman 10 , Naveed Akhtar 11 , Niaz Ahmed 2, 3 , Nils Wahlgren 2, 3 , Hany Aref 12 , Mohammed Almekhlafi 13 , Tiago Moreira 2, 3
Affiliation  

Background and methods

Stroke incidence and mortality are reported to have increased in the Middle-East and North African (MENA) countries during the last decade. This was a prospective observational study to examine the baseline characteristics of stroke patients in the MENA region and to compare the MENA vs. the non-MENA stroke cohort in the Safe Implementation of Treatments in Stroke (SITS) International Registry.

Results

Of the 13,822 patients with ischemic and hemorrhagic stroke enrolled in the SITS-All Patients Protocol between June 2014 and May 2016, 5897 patients (43%) were recruited in MENA. The median onset-to-door time was 5 h (IQR: 2:20–13:00), National Institutes of Health Stroke Scale (NIHSS) score was 8 (4–13) and age was 65 years (56–76). Hypertension (66%) and diabetes (38%) were the prevailing risk factors; large artery stenosis > 50% (25.3%) and lacunar strokes (24.1%) were the most common ischemic stroke etiologies. In comparison, non-MENA countries displayed an onset-to-door time of 5:50 h (2:00–18:45), a median of NIHSS 6 (3–14), and a median age of 66 (56–76), with other large vessel disease and cardiac embolism as the main ischemic stroke etiologies. Hemorrhagic strokes (10%) were less common compared to non-MENA countries (13.9%). In MENA, only a low proportion of patients (21%) was admitted to stroke units.

Conclusions

MENA patients are slightly younger, have a higher prevalence of diabetes and slightly more severe ischemic strokes, commonly of atherosclerotic or microvascular etiology. Admission into stroke units and long-term follow-up need to be improved. It is suspected that cardiac embolism and atrial fibrillation are currently underdiagnosed in MENA countries.



中文翻译:

中东和北非中风:对该地区中风特征进行的为期2年的前瞻性观察研究-安全实施中风治疗(SITS)的结果-中东和北非(MENA)


背景与方法

据报道,在过去的十年中,中东和北非(MENA)国家中风的发病率和死亡率有所增加。这是一项前瞻性观察性研究,旨在检查MENA地区中风患者的基线特征,并在《中风治疗安全实施(SITS)国际注册》中比较MENA与非MENA中风队列。

结果

在2014年6月至2016年5月的SITS-All Patient Protocol中纳入的13822例缺血性和出血性中风患者中,有5897例患者(43%)被招募到MENA中。上门平均起病时间为5小时(IQR:2:20-13:00),美国国立卫生研究院卒中量表(NIHSS)得分为8(4-13),年龄为65岁(56-76) 。高血压(66%)和糖尿病(38%)是主要的危险因素。大动脉狭窄> 50%(25.3%)和腔隙性脑卒中(24.1%)是最常见的缺血性卒中病因。相比之下,非MENA国家/地区的上门时间为5:50 h(2:00–18:45),NIHSS 6的中位数(3–14)和66岁的中位年龄(56– 76),以其他大血管疾病和心脏栓塞为主要的缺血性中风病因。与非MENA国家(13.9%)相比,出血性中风(10%)较少见。在中东和北非地区,

结论

MENA患者年龄较小,糖尿病的患病率较高,缺血性卒中的发生率稍高,通常是动脉粥样硬化或微血管病因引起的。需要改善卒中单元的入院率和长期随访。怀疑中东和北非国家目前对心脏栓塞和心房颤动的诊断不足。

更新日期:2019-03-12
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