Introduction: Stroke is one of the important causes of death and disability in Iran. This study aimed to examine the factors influencing the short-term mortality of stroke in Northwest of Iran.
Methods: Study population were all patients with confirming the diagnosis of the first-ever stroke who were hospitalized in two referral teaching hospitals from October 2013 to March 2015. They were followed up to 30 days after onset of stroke. A neurology year three resident was responsible for extracting the clinical data and assessment of stroke severity on admission using National Institute of Health Stroke Scale (NIHSS), and information about risk factors and socio-demographic factors were collected using face to face interview. Data were analysed using Cox proportional regression by STATA software version 14.
Results: A total of 1036 consecutive patients with first-ever stroke were included in this study. Of them, 228 patients (22%) died within 30 days after stroke accordance. Advanced age was significantly associated with a hazard for early mortality (HR=1.05 95% CI 1.09–1.04), the inverse was true for education level; mortality decreased as the education level increased; it was 25.7 percent among illiterate and 14.3 among patients with higher education. The NIHSS score on admission for 30-days mortality and hemorrhagic stroke were associated with HR=1.11 (95% CI 1.09–1.13) and HR= 1.65 (95% CI 1.15–2.36) respectively.
Conclusion:
Advanced age, stroke subtype and high NIHSS score are the independent predictors of early mortality in this study. This provides important implications for the clinicians to target the high-risk patients for the specific therapies and management strategies.
Caractéristiques et tendances épidémiologiques de l'incidence des morsures d'animaux dans la préfecture de Makou (République islamique d'Iran), 2003-2012RÉSUMÉ La présente étude a examiné les caractéristiques et l'incidence épidémiologiques dans le temps des morsures d'animaux dans la préfecture de Makou. Les données ont été obtenues à partir des registres de centres de santé portant sur les morsures d'animaux entre 2003 et 2012. Des informations sur les caractéristiques démographiques et les facteurs associés aux morsures d'animaux ont été enregistrées. Un total de 2232 personnes avaient été mordues. La fréquence des morsures était plus élevée parmi les hommes (75,4 %), les habitants ruraux (72,3 %) et les individus de moins de 20 ans (47,3 %). La plupart des morsures se situaient au niveau des jambes et des pieds (65 %) et les chiens étaient responsables de 92 % des morsures. Plus de 25 % des personnes mordues mettaient plus d'une journée à recourir à des soins, en particulier les habitants ruraux. L'incidence moyenne était de 250 pour 100 000 habitants, et on observait une tendance linéaire en hausse statistiquement significative sur la période de 10 ans. Il est nécessaire de sensibiliser le public, et particulièrement les habitants ruraux, à l'importance d'un traitement rapide. Eu égard à la tendance croissante des morsures d'animaux, une politique sanitaire pour s'attaquer à ce problème est requise. Most bites were to the legs and feet (65%) and dogs were responsible for 92% of bites. Over 25% of those bitten delayed seeking care for more than a day, particularly rural residents. The mean incidence was 250 per 100 000 population and there was a statistically significant increasing linear trend over the 10-year period. There is a need to raise public awareness, especially among rural residents, of the importance of early treatment. Given the increasing trend in animal bites, a health policy to tackle this problem is needed.
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