China’s response to the rising stroke burden

Li, Zixiao; Jiang, Yong; Li, Hao; Xian, Ying; Wang, Yongjun

doi:10.1136/bmj.l879

Cited by 101 publications

(88 citation statements)

References 28 publications

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“…Currently, stroke has become the second leading cause of death next to heart diseases, which killed 5.5 million persons per year (1). According to statistics, the aging of population was one of the major causes of increased incidence of stroke (2).…”

Section: Introductionmentioning

confidence: 99%

Mechanical Thrombectomy for Acute Ischemic Stroke in Octogenarians: A Systematic Review and Meta-Analysis

Zhao

Ping

et al. 2020

Front. Neurol.

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Background and purpose: Multiple randomized trials have confirmed that mechanical thrombectomy (MT) is an effective treatment method for patients with acute ischemic stroke (AIS). However, evidence on the safety and efficacy of MT in elderly patients compared with younger patients is controversial. This meta-analysis is aimed to systematically compare the outcomes of elderly patients and younger patients after MT for AIS.Methods: A systematic literature search was conducted through the PubMed, EMBASE, and Cochrane Library database. The primary outcomes were favorable functional outcome at 90 days and mortality. The secondary outcomes were symptomatic intracerebral hemorrhage (sICH) and successful recanalization rate. Odds ratios (ORs) were estimated using a random effects model. Results: Sixteen studies published between 2014 and 2019 were included in this meta-analysis totally involving 3,954 patients. The pooled results showed that patients aged ≥80 years had worse functional outcome (OR = 0.40; 95% CI, 0.32-0.50; P < 0.001) and higher rates of mortality (OR = 2.26; 95% CI, 1.73-2.95; P < 0.001). There was a trend of higher rates of sICH in patients aged ≥80 years compared with patients aged <80 years, whereas this did not reach statistical significance (OR = 1.28; 95% CI, 0.89-1.84; P = 0.18). Furthermore, the frequency of successful recanalization was also lower in patients aged ≥80 years compared with patients aged <80 years (OR = 0.72; 95% CI, 0.55-0.95; P = 0.02). The subgroup analysis indicated that in comparison with those studies published between 2014 and 2016, elderly patients undergoing MT had better outcomes in studies published between 2017 and 2019.Conclusion: Elderly patients undergoing MT had higher risk of mortality and worse functional outcome. Meanwhile, there was a trend toward higher rates of sICH and lower probability of achieving successful recanalization in elderly patients. These findings emphasize the need for improving the rates of successful recanalization in elderly patients Zhao et al.Mechanical Thrombectomy for Ischemic Stroke in Octogenarians with AIS. In addition, advanced technology of endovascular intervention and peri-interventional management might be associated with the prognosis in elderly patients. However, more prospective or randomized studies should be conducted to further explore this issue.

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Section: Introductionmentioning

confidence: 99%

Mechanical Thrombectomy for Acute Ischemic Stroke in Octogenarians: A Systematic Review and Meta-Analysis

Zhao

Ping

et al. 2020

Front. Neurol.

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“…Stroke is the leading cause of death in China (1). China's National Stroke Registry investigated patients who had previously experienced acute ischemic stroke and found that the 1-year recurrence rate of stroke was 17.7% (2).…”

Section: Introductionmentioning

confidence: 99%

Positive Influence of Stroke Health Manager on Risk Factors Control and Medication Adherence After Ischemic Stroke

Yan¹,

Liu²,

Guo³

et al. 2020

Front. Neurol.

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“…The rapidly ageing population is one of the major reasons for this high prevalence. (1,2) The location of stroke in the brain has a strong in uence on the clinical consequences. (3) In most cases, stroke occurs only in one hemisphere of the brain and results in impairment on the opposite side of the body.…”

Section: Introductionmentioning

confidence: 99%

Stroke Occurring on the Left or Right Side of the Brain Can Be Identified by the Analysis of Retinal Images: A Case Control Study

Zhuo¹,

Lin²,

Wu³

et al. 2020

Preprint

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Background: The burden of stroke in China has increased dramatically in the past 30 years. Specifying the treatment according to the side of stroke in the brain might be an effective way to reduce the burden. Current imaging tools to identify the side of brain stroke, such as magnetic resonance imaging (MRI), are expensive and time-consuming. Hence, there is a great need for a rapid and inexpensive assessment. In this case, retinal image analysis is a possible approach for stroke side identification. This study aimed at determining the association between retinal characteristics and the stroke side and to establish a predictive model for further investigation.Methods: A total of 168 patients (89 left-sided stroke patients and 79 right-sided stroke patients) were recruited from the Shenzhen Traditional Chinese Medicine Hospital in the study. Retinal characteristics were analysed using an automated retinal image analysis (ARIA) system. Multivariable logistic regression was used to identify and develop predictive models.Results: Each unit increase in the right eye bifurcation coefficient of arterioles increased the risk of right-side stroke by 7.523 times (95% CI, 1.823–31.044). Additionally, an elevated bifurcation coefficient of venules in the right eye also increased the risk of stroke in the right side of the brain, with an odds ratio (OR) of 7.377 (95% CI, 1.771–30.724). A complex retinal composite score was also associated with a higher risk of right-side stroke (OR, 4.955; 95% CI, 3.061–8.022).Conclusions: This study demonstrated that retinal images can provide useful information for stroke side identification, and specific retinal characteristics may help predict the occurrence of stroke.Trial registration: Acupuncture Clinical Trail Redistry, ChiCTR1800019647, Registered 01 November 2018, AMCTR-OPC-18000228.

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China’s response to the rising stroke burden

Abstract: Zixiao Li and colleagues discuss why the number of strokes is growing in China and how the country is taking steps to reduce the rate and improve care

Cited by 101 publications

References 28 publications

Mechanical Thrombectomy for Acute Ischemic Stroke in Octogenarians: A Systematic Review and Meta-Analysis

Mechanical Thrombectomy for Acute Ischemic Stroke in Octogenarians: A Systematic Review and Meta-Analysis

Positive Influence of Stroke Health Manager on Risk Factors Control and Medication Adherence After Ischemic Stroke

Stroke Occurring on the Left or Right Side of the Brain Can Be Identified by the Analysis of Retinal Images: A Case Control Study

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