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：

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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。