BackgroundIn Yakutia, the morbidity and mortality from stroke increased in the past 2 decades. Stroke share in the total mortality structure increased significantly. According to the autopsies, haemorrhagic stroke (HS) was more common in indigenous patients.ObjectiveThe aim of the study was to examine ethnic features of stroke patients of indigenous and non-indigenous ethnicity admitted to Regional Vascular Center (RVC), Yakutsk.DesignThe study used data from a hospital stroke registry, which took into account the cases of acute stroke in 2011. Stroke type and aetiology were determined by clinical examination, computed tomography and magnetic resonance imaging studies, cerebral angiography and ultrasound of cerebral vessels.ResultsA total of 1,108 patients were hospitalized (51.4% male, n=569) in 2011. The mean age was 60.5±12.9 years, male: 59.1±12.8, female: 61.9±13.05. Five hundred and ninety-two ischemic strokes (IS; 53.4%), 236 HS (21.3%), 280 transient ischemic attacks (TIA; 25.3%) were diagnosed. Patients who had a stroke were divided into 3 groups according to their ethnicity: native (n=411; 49.6%), Russians (n=347; 41.9%) and other nationalities (n=70; 8.5%). When comparing the incidence of HS in different ethnic groups, it was found that indigenous patients had more cases of HS than Russians (38% vs. 20.2%, p<0.05; adjusted odds ratio=2.42; 95% confidence interval: 1.72–3.41). Mean age of IS and HS indigenous patients had no significant differences compared with the average age of Russian ethnicity patients (p=0.69; p=0.201, respectively).ConclusionsThe data from this study suggest that among the patients who suffered from stroke in the indigenous population, the share of a haemorrhagic form washigher than those of non-indigenous Caucasians. At the same time, the average age of patients, both having IS and HS had no significant differences by ethnicity. Further studies are needed to establish the causes of ethnic differences of stroke in Yakutia.

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Relevance. Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition. Incorrect diagnosis of aSAH in a rural medical institution can lead to a delay in surgical treatment and worse outcomes of the disease in patients with ruptured cerebral aneurysms (CA). Objective. Analysis of diagnostic algorithms and evaluation of outcomes of surgical treatment of ruptured cerebral aneurysms in a region with a vast sparsely populated territory. Materials and methods. A retrospective analysis of the results of surgical treatment of 145 patients with aSAH, hospitalized in the Regional Vascular Center (RVC) in Yakutsk city, for 2017–2018 was carried out. The subjects were divided into 3 groups: group 1 — rural residents who were diagnosed with aSAH in rural medical institutions; group 2 — rural residents who were incorrectly diagnosed in rural medical institutions; group 3 — residents of Yakutsk who were hospitalized in the RVC by emergency medical services. Results. The study included 145 patients with aSAH. All patients underwent surgical treatment. The majority of patients (91 patients, i.e. 62.8 % of the total number of patients) were brought to the RVC by air medical service from the regions of the Republic. An erroneous diagnosis at the initial health encounter was established in 12 cases (8.3 % of the total number of aSAH cases), including in 11 cases in medical institutions of small villages (91.7 %) and only in 1 case in the Central District Hospital (8.3 %). Conclusions. During the initial health encounter of patients with aSAH, incorrect diagnoses were established in 8.3 %, of which 91.7 % were established in medical institutions of small villages. Emergency hospitalization of patients with suspected aSAH in the RVC ensures correct diagnosis of the disease and timely neurosurgical treatment.