Establishment of Population-Based Stroke Registry in Ludhiana City, Northwest India: Feasibility and Methodology

Abstract

Background/Aims: The Indian Council of Medical Research (ICMR) initiated the Task Force Project to evaluate the feasibility of conducting a population-based stroke registry in Ludhiana city, Punjab, Northwest India. Methods: All first-ever, stroke patients over 18 years from the city of Ludhiana were included in the study from March 26th 2010 to March 25th 2011. Stroke information was collected based on the WHO STEPS approach from the participating hospitals, scan centres and doctors. Modified Rankin Scale (mRS) was administered by telephonic interview at 28 days after stroke. The information on stroke deaths was obtained from the Municipal Corporation (MC) office. Results: A total of 905 first-ever stroke patients were documented. After excluding duplicate cases and patients from outside the city, 493 patients were included. The practical issues identified in data collection from these centres were reluctance to take informed consent, lack of willingness to share the data, difficulty to identify key persons from each centre, retrieving medical records from public hospitals and poor documentation of deaths in MC office. Conclusion: Population-based stroke registry was feasible in an urban population with the above methodology. The issues related to feasibility were identified and necessary changes were made for the main phase of the registry.

Stroke profile and outcome between urban and rural regions of Northwest India: Data from Ludhiana population-based stroke registry

“…When there was duplication of cases, the questionnaire with complete information was entered in the dataset. 13 In order to capture minor strokes and patients who solicit treatment outside the city, advertisements were placed in the newspaper every six months requesting these patients to contact the research team. 13 During the study, a total of 15 patients were ascertained by this method.…”

“…12 The data regarding demographic details, presenting symptoms, risk factors, type of stroke, diagnosis modalities were collected from hospitals, GPs and physiotherapy centers. 13 Information regarding demographic details, type of stroke and diagnosis modalities were collected from scan centres. The modified Rankin Scale was documented at 28 days using a structured interview on telephone for all hospital and scan centres patients.…”

Incidence & prevalence of stroke in India

“…Information from hospital-based studies on stroke : Given the insufficient number of population-based studies, information from hospital-based studies was also reviewed. Hospital-based registries for stroke in India have estimated cumulative stroke incidence based on the WHO STEPs 27 guidelines ( Table II ) 28 29 30 31 . Hospital-based stroke registries at Chennai and Bengaluru have not described the catchment population, and hence, it was not possible to calculate cumulative incidence of stroke from these studies 28 29 .…”

“…However, most of the rural patients did not report at the selected hospital sites in this study. The Ludhiana stroke registry estimated an age-adjusted cumulative stroke incidence of 155/100,000 people during the year 2011 31 .…”

Clinical features, risk factors, and short-term outcome of ischemic stroke, in patients with atrial fibrillation: Data from a population-based study

“…Data were collected using WHO-STEPS stroke approach from public hospitals, private hospitals (neurologists and neuro-surgeons), general practitioners (GP), physiotherapy centers, scan/imaging centers, and Municipal Corporation (MC). [ 14 15 ] All stroke patients ≥18 years with first-ever stroke between March 25, 2010, and March 25, 2013, were enrolled in this registry. There was the possibility of duplication of cases.…”