Stroke Mortality in Belgrade, Serbia: Age, Period, and Cohort Analyses

Pekmezović, Tatjana; Tepavčević, Darija Kisić; Jarebinski, M; Kostić, Milica; Bumbasirevic, Ljiljana

doi:10.1159/000104476

Cited by 12 publications

(7 citation statements)

References 30 publications

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“…However, it should be noted that CFR may differ with demographic and risk-factor profiles that change the distribution of ischemic stroke subtypes and thus also the stroke severity and risk of death 6. The contribution of economic and social factors to stroke CFR in Serbia which limit access to effective treatment and stroke prevention2 cannot be excluded. Additionally, the long-term survival rates in our study are also lower than those reported previously 11,13,19…”

Section: Discussionmentioning

confidence: 99%

Short-Term and Long-Term Stroke Survival: The Belgrade Prognostic Study

et al. 2013

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Background and PurposeThe aims of this study were to determine the 28-day and 1-year survival rates after first-ever ischemic stroke and to identify their baseline predictors.MethodsWe prospectively and consecutively collected data on 300 patients with first-ever acute ischemic stroke admitted to 2 major neurological institutions for cerebrovascular diseases in Belgrade during March 2008. The Kaplan-Meier method was used to estimate the cumulative 28-day and 1-year survival rates, and the predictive values of different variables were assessed by Cox proportional-hazards regression model.ResultsThe cumulative 28-day and 1-year survival rates of ischemic stroke patients in the cohort were 81.0% and 78.3%, respectively. The multivariate predictive model revealed that hypertension (p=0.017), National Institutes of Health Stroke Scale score (p=0.001), and in-hospital medical complications (p=0.029) were significant unfavorable independent outcome predictors, while early physical therapy (p=0.001) was a significant favorable prognostic factor for the 28-day mortality in our patients. Multivariate Cox regression analysis showed that age (p=0.001), National Institutes of Health Stroke Scale score (p=0.001), and in-hospital complications (p=0.008) remained significant predictors of 1-year mortality.ConclusionsThe findings support the need for optimal control of vascular risk factors and treatment of atherosclerotic disease as well as appropriate prevention and management of in-hospital complications of stroke.

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Section: Discussionmentioning

confidence: 99%

Short-Term and Long-Term Stroke Survival: The Belgrade Prognostic Study

et al. 2013

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“…These events resulted in a dramatic increase in poverty and the collapse of the health care system. During this period, the management of vascular risk factors was not a priority for the health care system [4]. After 2000, the situation started to improve, and in 2008, the GDP per inhabitant was USD 6,870 [5].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Thrombolysis for Acute Cerebral Ischemia in Belgrade, Serbia: Comparison with Lille, France

Bogosavljević¹,

Bodenant

Beslac-Bumbasirevic³

et al. 2011

Eur Neurol

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Background: Worse socioeconomic situation is associated with worse outcomes in stroke cases. Whether it also influences outcomes in patients treated with intravenous thrombolysis remains unknown. The aim of this study was to test the hypothesis that outcomes are less favorable in patients treated with intravenous thrombolysis in Belgrade, Serbia, than in Lille, France. Methods: We compared outcomes at day 7 and month 3, between 123 consecutive stroke patients treated with intravenous thrombolysis in Belgrade and 273 in Lille. Results: At month 3, there was no significant difference between Belgrade and Lille in patients’ excellent outcomes [modified Rankin Scale 0–1; 49.6 vs. 45.4%, odds ratio (OR): 1.21, 95% confidence interval (CI): 0.79–1.86] or in death (11.4 vs. 16.1%, OR 0.67, 95% CI: 0.35–1.27). However, compared with a subgroup of age-matched patients from Lille, Belgrade patients tended to have worse outcomes. Patients from Belgrade were 16 years younger (p < 0.0001), more likely to be men (OR 2.40, 95% CI: 1.52–3.78), and more likely to be smokers (OR 2.24, 95% CI: 1.43–3.51). Also, a trend for a slightly higher rate of symptomatic hemorrhagic transformation was registered in this group (7.3 vs. 3.3%, OR 2.32, 95% CI: 0.90–5.99). In Belgrade, patients arrived 27 min earlier to the hospital (p < 0.0001), but their door-to-needle time was 37 min longer (p < 0.0001). Compared with a subgroup of age-matched patients from Lille, they tended to have worse outcomes. Conclusion: Intravenous thrombolysis-treated stroke patients in Belgrade have similar outcomes and rates of complications as those from Lille.

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“…Medical services were administered on a priority basis and for urgent cases only, because the health service could not cope with all of its tasks. For example, we demonstrated a rapid increase in stroke mortality in the population of Belgrade during the period of 1994-1998 as a manifestation of these unfavorable living conditions [18] . Keeping this in mind, it is reasonable to assume that these events could have affected MS case identification and ascertainment.…”

Section: Discussionmentioning

confidence: 85%

Prevalence of Multiple Sclerosis in the Serbian District Sumadija

et al. 2011

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Background: The aim of this study was to estimate the prevalence of multiple sclerosis (MS) in the district of Sumadija (central part of Serbia). Methods: All persons suffering from MS, with permanent residence in the region, were recruited. Prevalence was calculated on December 31, 2006, according to a standard procedure. Results: On December 31, 2006, one hundred ninety-four patients (72 males and 122 females) were found to have MS. We found a crude MS prevalence of 64.9/100,000 (49.3/100,000 for males and 79.9/ 100,000 for females). The highest prevalence rates were registered in the age group of 30–39 years for females and 40–49 years for males, although the age-specific rates were higher in females in all age groups. The mean age at onset was 34.2 ± 9.3 years. The average duration of MS was 8.9 ± 6.2 years. The median EDSS score was 3.9 ± 2.0. The course of MS was relapsing-remitting in 63.9% of patients, secondary progressive in 32.5%, and primary progressive in 3.6%. At MS onset, motor symptoms were present in 70.1% of patients, sensory in 40.7%, cerebellar in 21.1%, brainstem in 15.5%, visual in 22.2%, and bowel/bladder disturbances in 22.2%. Conclusions: Our results demonstrate that the MS prevalence registered in the Serbian district Sumadija is similar to that of other surrounding areas in Southeastern Europe.

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Stroke Mortality in Belgrade, Serbia: Age, Period, and Cohort Analyses

Cited by 12 publications

References 30 publications

Short-Term and Long-Term Stroke Survival: The Belgrade Prognostic Study

Short-Term and Long-Term Stroke Survival: The Belgrade Prognostic Study

Intravenous Thrombolysis for Acute Cerebral Ischemia in Belgrade, Serbia: Comparison with Lille, France

Prevalence of Multiple Sclerosis in the Serbian District Sumadija

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