Population Group Differences in Trends in Stroke Mortality in Israel

Koton, Silvia; Bornstein, Natan M.; Green, Manfred S.

doi:10.1161/hs0901.095407

Cited by 10 publications

(12 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Higher age-adjusted mortality rates were previously found among both Arab men and women compared to Jewish counterparts [4,13]. Conversely, we found no statistically significant differences in mortality rates between Arabs and Jews after adjusting for age, or after adjusting for additional potential confounders.…”

Section: Discussioncontrasting

confidence: 74%

See 1 more Smart Citation

Ethnic Variations in Acute Ischemic Stroke: Findings from the National Acute Stroke Israeli Survey (NASIS)

Gross

Feldman-Idov²,

Molshatzki³

et al. 2011

Cerebrovasc Dis

Self Cite

View full text Add to dashboard Cite

Background: We intended to determine ethnic differences in the characteristics, management and outcome of acute ischemic stroke between the Israeli Arab and Jewish populations. Methods: A national survey was conducted in 2004 at all 28 hospitals in Israel. Information on demographics, transportation, risk factors, clinical presentation, stroke severity, type and subtype, management and clinical outcome was obtained. Mortality during the 36 months after hospitalization was assessed by matching with national mortality data. Results: Of the 1,540 patients, 169 (11%) were Arabs and 1,371 (89%) were Jews. The mean age of Arab patients was 9 years younger than in Jewish patients (63 ± 11 vs. 72 ± 12 years). Also, Arabs were more likely to be obese (OR = 1.72; 95% CI: 1.19–2.50) and have diabetes (OR = 1.41; 95% CI: 1.01–1.96), while Jews were more likely to have dyslipidemia (OR = 1.56; 95% CI: 1.11–2.17). A greater percentage of the Arab patients arrived at the hospital independently (OR = 3.85; 95% CI: 2.56–5.56) and were less likely to arrive within 3 h of symptom onset (OR = 2.33; 95% CI: 1.39–3.85). Arabs suffered increased rates of lacunar stroke (OR = 1.67; 95% CI: 1.14–2.43) and were discharged home more often (OR = 2.40; 95% CI: 1.35–4.25). No differences in severity of stroke, management, complications, disability or mortality were found between the 2 groups. Conclusions: The unique characteristics of the Arab and Jewish populations should be considered when planning stroke-care services and culturally oriented public education programs.

show abstract

Section: Discussioncontrasting

confidence: 74%

“…Mortality was the only prognostic clinical outcome with conclusive evidence for disparities [12]. Differences in stroke mortality were also found in Israel between Jewish and Arab populations [13]. …”

Section: Introductionmentioning

confidence: 99%

Ethnic Variations in Acute Ischemic Stroke: Findings from the National Acute Stroke Israeli Survey (NASIS)

Gross

Feldman-Idov²,

Molshatzki³

et al. 2011

Cerebrovasc Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Age-adjusted mortality rates after stroke have declined considerably during the last decades in Israel. However, mortality trends show a greater decline for Jews than for Arabs, a finding probably related to differences in risk factor distribution [8] .…”

Section: Introductionmentioning

confidence: 93%

Mortality and Predictors of Death 1 Month and 3 Years after First-Ever Ischemic Stroke: Data from the First National Acute Stroke Israeli Survey (NASIS 2004)

Koton¹,

Tanné²,

Green³

et al. 2009

Neuroepidemiology

View full text Add to dashboard Cite

Background: Despite declining age-adjusted stroke mortality rates, the disease remains the third most common cause of death in Israel. Based on a national survey, we examined mortality rates during the first 3 years after a first-ever acute ischemic stroke (IS) and the major predictors of short-term (1 month) and long-term (3 years) mortality. Methods: In the National Acute Stroke Israeli Survey (NASIS 2004), data were collected on all hospitalized stroke patients in Israel during a 2-month period. Mortality rates for first-ever IS were assessed at 1 month and 3 years and predictors of death were evaluated using the Cox proportional hazard model. Results: A total of 1,079 first-ever IS patients were included. Survival data were complete for over 99% of patients. Cumulative mortality rates were 9.9% at 1 month and 31.1% at 3 years. Of the survivors at 1 month, 23.5% did not survive for 3 years. At 1 month, the hazard ratio (HR) for death significantly increased with stroke severity. One-month mortality was also associated with a decreased level of consciousness (HR 2.9, 95% CI 1.7–5.1), total anterior circulation infarction (TACI); HR 4.9, 95% CI 1.6–15.2), temperature on admission (HR 1.5, 95% CI 1.1–2.1 per 1°C), age (HR 1.04, 95% CI 1.02–1.07 per year) and glucose levels on admission (HR 1.003, 95% CI 1.001–1.006 per 1 mg/dl). Age-adjusted proportions of diabetes and chronic heart failure were considerably higher in the deceased compared with survivors at 3 years (48 vs. 38 and 21 vs. 9%, respectively). In the multivariate survival analyses, predictors of death at 1 month also predicted death at 3 years; however, history of dementia (HR 1.5, 95% CI 1.0–2.4), diabetes (HR 1.6, 95% CI 1.0–2.4), peripheral artery disease (HR 1.7, 95% CI 1.1–2.8), chronic heart failure (HR 1.6, 95% CI 1.1–2.4) and malignancy (HR 1.7, 95% CI 1.1–2.7) were additional predictors of long-term mortality for patients surviving the first month after stroke. Conclusions: Approximately one third of patients did not survive 3 years after the first-ever IS. While age and markers of severe stroke were the major predictors of death at 1 month, comorbidities and variables associated with atherosclerotic vascular disease predicted long-term mortality. Improved control of these factors can potentially reduce long-term mortality in stroke victims.

show abstract

“…In a recent study comparing trends in stroke mortality among Jewish and Arab populations residing in Israel, a significant difference was found in the group of 75 years and older: a statistically significant decrease in mortality rates for Jews was evident, while no such a decrease was apparent for Arabs [13]. In the Israeli Ischemic Heart Disease Project, after 21 years of follow-up, higher ageadjusted mortality rates attributed to ischemic stroke were found for immigrants from North Africa compared to 3 parts of Europe (Central Europe, Eastern Europe and the Balkan countries) [14].…”

Section: Discussionmentioning

confidence: 97%