title: National data on stroke outcomes in Thailand.
abstract: Stroke is a major public health problem worldwide. There are limited data on national stroke prevalence and outcomes after the beginning of the thrombolytic therapy era in Thailand. This study aimed to investigate the prevalence and factors associated with mortality in stroke patients in Thailand using the national reimbursement databases. Clinical data retrieved included individuals under the universal coverage, social security, and civil servant benefit systems between 1 October 2009 and 30 September 2010. The stroke diagnosis code was based on the International Classification of Diseases 10th revision system including G45 (transient cerebral ischemic attacks and related syndromes), I61 (intracerebral hemorrhage), and I63 (cerebral infarction). The prevalence and stroke outcomes were calculated from these coded data. Factors associated with death were evaluated by multivariable logistic regression analysis. We found that the most frequent stroke subtype was cerebral infarction with a prevalence of 122 patients per 100,000 of population, an average length of hospital stay of 6.8 days, an average hospital charge of 20,740 baht (∼$USD 691), a mortality rate of 7%, and thrombolytic prescriptions of 1%. The significant factors associated with stroke mortality were septicemia, pulmonary embolism, pneumonia, myocardial infarction, status epilepticus, and heart failure. In conclusion, the prevalence and outcomes of stroke in Thailand were comparable with other countries. The era of thrombolytic therapy has just begun in Thailand.
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; North-eastern Stroke Research Group, Khon Kaen University, Thailand.
authors.forename: Kannikar
authors.initials: K
authors.lastname: Kongbunkiat
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
authors.forename: Narongrit
authors.initials: N
authors.lastname: Kasemsap
authors.affiliation: Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kaewjai
authors.initials: K
authors.lastname: Thepsuthammarat
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; North-eastern Stroke Research Group, Khon Kaen University, Thailand.
authors.forename: Somsak
authors.initials: S
authors.lastname: Tiamkao
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand. Electronic address: kittisak@kku.ac.th.
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications; D002544:Cerebral Infarction / Q000188:drug therapy; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D017722:Hospital Charges; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D013785:Thailand / Q000453:epidemiology; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents
keywords: ICD-10; National data; Outcomes; Predictors; Stroke; Thailand