Trends in risk factors, stroke subtypes and outcome. Nineteen-year data from the Sagrat Cor Hospital of Barcelona stroke registry.
BACKGROUND
Prospective stroke registries allow analyzing important aspects of the natural history of acute cerebrovascular events. Using the Sagrat Cor Hospital of Barcelona Stroke Registry, we aimed to determine trends in risk factors, stroke subtypes, prognosis and in-hospital mortality over 19 years in hospitalized stroke patients.


METHODS
The study population consisted of 2,416 first-ever stroke patients (ischemic stroke, n = 2,028; intracerebral hemorrhage, n = 334) included in the stroke registry up to December 31, 2004. Temporal trends in stroke patient characteristics for the periods 1986-1992, 1993-1998 and 1999-2004 were assessed.


RESULTS
Age was significantly different among the analyzed periods (p < 0.001), showing an increment in older patients throughout time. Hypertension (p = 0.001), diabetes (p = 0.004), ischemic heart disease (p = 0.002) and atrial fibrillation increased (p = 0.000) as opposed to heavy smoking (p = 0.000) and history of TIA (p = 0.025). The mortality rate and the length of hospital stay decreased (p = 0.001), whereas transfer to convalescent/rehabilitation units increased (p = 0.001).


CONCLUSIONS
An improvement in acute-stroke management and possibly evolution of cerebrovascular risk factors is reflected by changes in the risk factors and outcome of first-ever stroke patients admitted to a stroke unit over a 19-year time span.
Arboix
Adrià
A
Department of Neurology, Cerebrovascular Division, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Spain. aarboix@hscor.com
Cendrós
Victòria
V
Besa
Marta
M
García-Eroles
Luís
L
Oliveres
Montserrat
M
Targa
Cecília
C
Balcells
Miquel
M
Comes
Emili
E
Massons
Joan
J
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000401:mortality; D048909:Diabetes Complications / Q000209:etiology / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D002546:Ischemic Attack, Transient / Q000150:complications / Q000401:mortality; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality; D016017:Odds Ratio; D010360:Patient Transfer; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome