Stroke subtypes in southern Iran

Safari, Rasool; Borhani‐Haghighi, Afshin; Heydari, Seyed Taghi; Safari, Anahid; Cruz‐Flores, Salvador

doi:10.31661/gmj.v4i1.359

GMJ

2015

DOI: 10.31661/gmj.v4i1.359

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Stroke subtypes in southern Iran

Rasool Safari

Afshin Borhani‐Haghighi

Seyed Taghi Heydari

et al.

Abstract: Objective: To investigate about frequency of different subtypes of stroke in south of IranMethods: This is a retrospective, single-center study conducted at Namazi Hospital, Shiraz, south of Iran. Age, sex, length of hospitalization and mortality of stroke patients were recorded by reviewing hospital medical records.Results: 16 351 patients (53.6% male, 46.4%female) were recruited. Ischemic stroke (10750 patients, 65.7%), intracerebral hemorrhage(3282 patients,20.1%) and subarachnoid hemorrhage(1057 pati… Show more

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2024

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“…Meanwhile, epidemiological characteristics of stroke in Iranian population are different with other countries. Both population-based and hospital-based studies showed that incidence and mortality of stroke in Iran is higher than most western countries [1,2]. Higher rates of patients with young-adult stroke in Iranian population are a prominent feature too [3].…”

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Review of Stroke: The 2nd International and the 8th National Iranian Stroke Congress : Shiraz, Iran

Borhani-Haghighi

2016

GMJ

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Dear reader, Stroke is a major health problem in Iran as other developing countries.Â Meanwhile, epidemiological characteristics of stroke in Iranian population are different with other countries.Â Both Â population-based and hospital-based studies showed that Â incidence and mortality of stroke in Iran is higher than most western countries [1,2]. Higher rates of patients with young-adult stroke in Iranian population are a prominent feature too [3]. In the same time, prevalence of cerebral venous sinus thrombosis is higher than western populations [4] but the frequency of the intracranial stenosis is more or less same as Europeans [5]. The high prevalence of atherosclerotic disease in Iran can be attributed to social and economic factors, including increased life span, changes in dietary habits and an increasingly sedentary lifestyle [6]. In the light of these changes, Iranian health policymakers should consider concerted primary and secondary preventive measures to reduce the impact of this increasingly problematic public health issue. Iranians who have had a stroke consider their social, financial and rehabilitative support to be inadequate. Moreover, awareness of the manifestations of stroke is poor in the Iranian general population [7]. Consequently, the clinical status of stroke patients by the time they are transferred to the referral center may be worse than it could have been. There is an urgent need for Iranian hospitals to develop better measures to manage acute stroke patients. The second international Iranian stroke congress was held from 23-25 September 2015 in Shiraz, Iran. This Conference was a joint effort of the Clinical Neurology Research Center of Shiraz University of Medical Sciences and Iranian Stroke Association. Here we presented Â some selected reviews from outstanding platforms of this congress. Ghandehari presented the epidemiology of stroke in Iran [8]. Safari et al presented a comprehensive review about immunology of stroke [9]. Abolhasani-Foroughi andÂ Nazeri Â summarized the role of Computed topographyÂ scan for diagnosis and treatment planning of stroke patients [10]. Lotfi discussed about pearls and pitfalls of color doppler sonography of cervical arteries [11]. We also have three reviews about clinical and radiologic aspects of cerebral venous sinus thrombosis [12-14]. Two reviews focused on importance of rehabilitation in new stroke era [15,16]. Â

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confidence: 99%

Review of Stroke: The 2nd International and the 8th National Iranian Stroke Congress : Shiraz, Iran

Borhani-Haghighi

2016

GMJ

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A model for priority setting of health technology assessment: the experience of AHP-TOPSIS combination approach

et al. 2016

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BackgroundIn recent times, the use of health technologies in the diagnosis and treatment of diseases experienced considerable and accelerated growth. The goal of the present study was to describe the designated pilot MCDM (Multiple Criteria Decision Making) model for priority setting of health technology assessment in Iran.MethodsRelevant articles were sought and retrieved from the most appropriate medical databases, including the Cochrane Library, PubMed and Scopus via three separate search strategies, using MESH and free text until March, 2015. Retrieved criteria were questioned from health technology assessment experts in two rounds and the relative weight for valid criteria was finally obtained from paired wise comparison method. After extraction of relative weights based on the aforementioned procedure, TOPSIS (The Technique for Order of Preference by Similarity to Ideal Solution) priority setting model was designed. The stated model was applied for assessing three technologies (adenosine, tissue plasminogen activator and mechanical thrombectomy) which were available for projects call of Iranian health technology assessment department in order to determine applicability of the model for practical purpose.ResultsNine criteria, including efficiency/effectiveness, safety, population size, vulnerable population size, availability of alternative technologies, cost effectiveness in other countries, budget impact, financial protection, quality of evidence, were extracted by the Iranian health technology assessment experts. The relative weights of these criteria were as follows 0.12, 0.2, 0.06, 0.08, 0.08, 0.13, 0.08, 0.09, and 0.15, respectively. Finally TOPSIS pilot model was designed by three health technologies and nine criteria relative weights. Results showed that, the applicability of the stated model was suitable and as the pilot testing, tissue plasminogen activator was the first priority, adenosine was second and mechanical thrombectomy was third for performing health technology assessment by the Iranian ministry of health and medical education.ConclusionAccording to the results of this study, this model with nine effective criteria and their relative weights and in combination with TOPSIS approach could be used with suitable applicability by health technology assessment department in deputy of curative affairs and food and drug organization for determination of research priorities in health technology assessment.

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Cost-Effectiveness Analysis of Rehabilitation Methods for Stroke Survivors

Miri,

Jahanmehr,

Goudarzi

2024

Middle East J Rehabil Health Stud

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Background: One of the challenges in stroke management is how to provide rehabilitation services to stroke patients in Iran. Objectives: This study aimed to evaluate and compare the cost-effectiveness of rehabilitation interventions for stroke patients in three settings: hospitals, stroke units, and homes. Methods: This cross-sectional study was conducted from the perspective of the health system. A Markov model with a 20-year time horizon and 3-month cycles was used to analyze costs and outcomes. Cost data were collected from 210 patients undergoing rehabilitation in hospitals, homes, or stroke units. The cost-effectiveness analysis (CEA) was conducted by calculating the incremental cost-effectiveness ratio (ICER) using Tree Age software. Results: The average rehabilitation cost for the home strategy ($2306 ± 35.018) was less than that for the hospital ($2955 ± 48.18) and stroke unit ($3485 ± 51.63) strategies. Furthermore, the QALY of the home strategy (26.03) was 8 times higher than that of the hospital (17.99) and 19 times higher than that of the stroke unit (7.03). The average cost-effectiveness ratios for the hospital, stroke unit, and home groups were $11424, $33159, and $7233 per QALY, respectively. The ICERs for stroke unit and home rehabilitation relative to hospital rehabilitation were $2517 and $2145 per QALY, respectively. Conclusions: According to the results, the home-based rehabilitation strategy is more cost-effective than hospital and stroke unit rehabilitation strategies. Given the high rates of stroke and its associated costs in Iran, it is suggested that policymakers lay the groundwork for providing these services at home.

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Stroke subtypes in southern Iran

Cited by 3 publications

References 7 publications

Review of Stroke: The 2nd International and the 8th National Iranian Stroke Congress : Shiraz, Iran

Review of Stroke: The 2nd International and the 8th National Iranian Stroke Congress : Shiraz, Iran

A model for priority setting of health technology assessment: the experience of AHP-TOPSIS combination approach

Cost-Effectiveness Analysis of Rehabilitation Methods for Stroke Survivors

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