Vital and functional outcomes of the first-ever hemispheric stroke, epidemiological comparative study between Kunming (China) and Limoges (France).
BACKGROUND
Clinical outcomes and socioeconomic consequences after a stroke may differ between regions.


METHODS
One cohort was established prospectively in Kunming (China) to compare with a cohort of 156 stroke patients included in Limoges (France). During 1 year, patients hospitalized within 48 hours for a first-ever hemispheric stroke were included. Demographic data and neurocardiovascular risk factors were registered. Hemiplegia was evaluated. Functional outcome was assessed using the Barthel Index (BI) after 3 months.


RESULTS
One hundred and eighteen patients were included in Kunming. Patients of Kunming were younger (61.4 ± 13.4 vs 72.3 ± 14.6 years in Limoges, P<0.0001), more involved in professional activity (36.4% vs 12.8%, P<0.0001). Survival analysis indicated that mortality did not differ between cohorts, but independently predicted by coma at the 2nd day (HR=9.33, 95% CI [4.39, 19.78]) and age>70 years (HR=6.29, 95% CI [2.36, 16.59]). Despite a better baseline BI for patients of Kunming (50.0 ± 34.9 vs 37.4 ± 34.2, P=0.0031), after adjustment for confusing, patients in Limoges had a 2.11 OR 95% CI [1.03, 4.31]) to reach a BI>80 at 3 months.


CONCLUSIONS
Functional recovery for patients of Kunming was not as good as expected. The socioeconomic consequences of stroke in Kunming are significant as they involved younger subjects who were still in work.
Zhou
Z
Z
The Second Affiliated Hospital of Kunming Medical University, Neurology Department, Kunming, China.
Daviet
J-C
JC
Marin
B
B
Macian
F
F
Salle
J-Y
JY
Zhou
N
N
Zhu
Y
Y
D000368:Aged; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology*; D002391:Catchment Area, Health; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000453:epidemiology / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology