Stroke incidence and mortality in rural and urban Shanghai from 1984 through 1991. Findings from a community-based registry.

Cadilhac

Andrew

et al. 2014

Stroke

A t least ≥30% of strokes in China are intracerebral hemorrhages (ICH) when compared with ≈15% in Western countries, with a noticeable south-north gradient. [1][2][3][4] In absolute terms, this equates to large numbers of cases in China, and interventions to reduce the effects of ICH are important to determine. This is because ICH is generally more severe than ischemic stroke 5 and is associated with poorer functional outcome and higher case-fatality. 6 Evidence suggests that very early physical rehabilitation (VER) of stroke survivors may result in better motor recovery, reduced mental, functional and neurological disability, and improved quality of life. 7-11However, previous studies have included only small proportions of people with ICH, 8,10 and further research in large phase III studies for all stroke subtypes is still needed. 12Patients who have experienced ICH may differ to those with ischemic stroke in regards to risk factors, mechanisms of Background and Purpose-Mechanisms, acute management, and outcomes for patients who experience intracerebral hemorrhage may differ from patients with ischemic stroke. Studies of very early rehabilitation have been mainly undertaken in patients with ischemic stroke, and it is unknown if benefits apply to those with intracerebral hemorrhage. We hypothesized that early rehabilitation, within 48 hours of stroke, would improve survival and functional outcomes in patients with intracerebral hemorrhage. Methods-This was a multicenter, randomized controlled study, with blinded assessment of outcome at 3 and 6 months.Eligible patients were randomized to receive standard care or standard care plus early rehabilitation. Primary outcome includes survival. Secondary outcomes includes health-related quality of life using the 36-item Short Form Questionnaire, function measured with the modified Barthel Index, and anxiety measured with the Zung Self-Rated Anxiety Scale. Results-Two hundred forty-three of 326 patients were randomized (mean age, 59 years; 56% men). At 6 months, patients receiving standard care were more likely to have died (adjusted hazard ratio,

Section: Limitationssupporting

confidence: 92%

“…[1][2][3][4] In absolute terms, this equates to large numbers of cases in China, and interventions to reduce the effects of ICH are important to determine. This is because ICH is generally more severe than ischemic stroke 5 and is associated with poorer functional outcome and higher case-fatality.…”

mentioning

confidence: 99%

Randomized Controlled Trial of Early Rehabilitation After Intracerebral Hemorrhage Stroke

Cadilhac

Andrew

et al. 2014

Stroke

“…1,2 The risk factor profiles and prevention strategies are different for ischemic and hemorrhagic stroke, 3 so it is important to clarify the proportion of stroke subtypes. Most previous studies suggested that at least 30% of strokes in China were hemorrhagic strokes 4,5 ; some studies even reported that Ͼ50% of strokes were hemorrhagic, 6 which was significantly different from the findings in whites. [7][8][9][10][11][12][13][14][15][16] However, most of these previous studies either limited the study population to a confined area or based the diagnosis criteria mainly on clinical presentations.…”

mentioning

confidence: 87%

“…[7][8][9][10][11][12][13][14][15][16] Previous studies in China, Hong Kong, Taiwan, and Japan generally found that 23% to 52.2% of strokes were hemorrhagic, [3][4][5][6][21][22][23][24][25] in contrast to only 9% to 18% in whites. [7][8][9][10][11][12][13][14][15][16] In the present study, 29.6% of stroke cases overall in 2000 were hemorrhagic in Chinese populations, which supported the above idea that an ethnic difference existed between Eastern and Western populations.…”

Section: Stroke Subtypes In Chinese Populations Compared With Westernmentioning

confidence: 99%

Proportion of Different Subtypes of Stroke in China

Zhang

Yang

Hong

et al. 2003

Stroke

315

193

Background and Purpose-The goal of this article is to clarify the proportion of stroke subtypes in China, where stoke is the most common cause of death. Methods-A total of 16 031 first-ever strokes in subjects Ն25 years of age were identified in 1991 to 2000 from 17 Chinese populations through a community-based cardiovascular disease surveillance program in the China Multicenter Collaborative Study of Cardiovascular Epidemiology. World Health Organization diagnosis criteria were used for classification of stroke subtypes. Results-CT scan rate of stroke cases reached a satisfactorily high level only after 1996 in the study populations. In 8268 first-ever stroke events from 10 populations with CT scan rate Ͼ75% in 1996 to 2000, 1.8% were subarachnoid hemorrhage, 27.5% were intracerebral hemorrhage, 62.4% were cerebral infarction, and 8.3% were undetermined stroke. The proportion of intracerebral hemorrhage varied from 17.1% to 39.4% and that for cerebral infarction varied from 45.5% to 75.9% from population to population. The ratio of ischemic to hemorrhagic stroke ranged from 1.1 to 3.9 and averaged 2.0). The 28-day fatality rate was 33.3% for subarachnoid hemorrhage, 49.4% for intracerebral hemorrhage, 16.9% for cerebral infarction, and 64.6% for undetermined stroke. Conclusions-In our study, ischemic stroke was more frequent and its proportion was higher than hemorrhagic stroke in Chinese populations. Although hemorrhagic stroke was more frequent in Chinese than in Western populations, the variation in the proportion of stroke subtypes among Chinese populations could be as large as or larger than that between

“…The previous studies suggested that at least 30% of strokes in China were HS (Hong et al. 1994). The risk factor profiles and prevention strategies are different for ischemic and hemorrhagic stroke (Leppala et al.…”

Section: Introductionmentioning

confidence: 99%

Polymorphisms in three genes are associated with hemorrhagic stroke

Ge²,

et al. 2015

Brain and Behavior

BackgroundMultiligand receptor for advanced glycation end products (RAGE), osteoprotegerin, and Golgb1 genes may be implicated in atherosclerosis and vascular diseases. Single nucleotide polymorphisms (SNPs) rs1035798 in RAGE gene, rs2073617 and rs2073618 in TNFRSF11B, and rs3732410 in Golgb1 will be investigated on whether there is an association with hemorrhagic stroke (HS) in Chinese population.MethodsA total of 600 subjects including 199 HS patients and 401 controls were assayed. These samples were divided into two groups: the ≤50 year and >50 year groups. Genotyping of SNPs was determined using the SEQUENOM MassARRAY matrix‐assisted laser desorption ionization–time‐of‐flight–mass spectrometry. The association between genotype and HS risk was evaluated by computing the odds ratio (OR) and 95% confidence interval (CI) with multivariate unconditional logistic regression analyses.ResultsOur data showed that in the ≤50 year group, the rs1035798 major allele homozygote C/C in RAGE gene was associated with an increased risk of HS, while Golgb1 rs3732410 minor allele homozygote G/G was associated with a decreased risk of HS. In the >50 year group, the major allele homozygote G/G of rs2073618 was found to be associated with an increased risk of HS.ConclusionsThe polymorphisms rs1035798 of RAGE gene, rs2073618 of TNFRSF11B, and rs3732410 of Golgb1 might be involved in the risk of HS at different stage of ages.