Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database
BackgroundPosterior cerebral circulation ischemic stroke (PCS) comprises up to 25% of all strokes. It is characterized by variable presentation, leading to misdiagnosis and morbidity and mortality. We aim to describe PCS in large multiethnic cohorts.MethodsA retrospective review of a large national...
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1302298/full |
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| author | Yahia Z. Imam Yahia Z. Imam Yahia Z. Imam Prem Chandra Rajvir Singh Ishrat Hakeem Sally Al Sirhan Mona Kotob Naveed Akhtar Naveed Akhtar Naveed Akhtar Saadat Kamran Saadat Kamran Salman Al Jerdi Ahmad Muhammad Ahmad Muhammad Khawaja Hasan Haroon Suhail Hussain Jon D. Perkins Osama Elalamy Osama Elalamy Mohamed Alhatou Liaquat Ali Mohamed S. Abdelmoneim Sujatha Joseph Deborah Morgan Ryan Ty Uy Zain Bhutta Aftab Azad Aftab Azad Ali Ayyad Ahmed Elsotouhy Ahmed Own Dirk Deleu Dirk Deleu |
| author_facet | Yahia Z. Imam Yahia Z. Imam Yahia Z. Imam Prem Chandra Rajvir Singh Ishrat Hakeem Sally Al Sirhan Mona Kotob Naveed Akhtar Naveed Akhtar Naveed Akhtar Saadat Kamran Saadat Kamran Salman Al Jerdi Ahmad Muhammad Ahmad Muhammad Khawaja Hasan Haroon Suhail Hussain Jon D. Perkins Osama Elalamy Osama Elalamy Mohamed Alhatou Liaquat Ali Mohamed S. Abdelmoneim Sujatha Joseph Deborah Morgan Ryan Ty Uy Zain Bhutta Aftab Azad Aftab Azad Ali Ayyad Ahmed Elsotouhy Ahmed Own Dirk Deleu Dirk Deleu |
| author_sort | Yahia Z. Imam |
| collection | DOAJ |
| description | BackgroundPosterior cerebral circulation ischemic stroke (PCS) comprises up to 25% of all strokes. It is characterized by variable presentation, leading to misdiagnosis and morbidity and mortality. We aim to describe PCS in large multiethnic cohorts.MethodsA retrospective review of a large national stroke database from its inception on the 1st of January 2014 till 31 December 2020. Incidence per 100,000 adult population/year, demographics, clinical features, stroke location, and outcomes were retrieved. We divided the cohort into patients from MENA (Middle East and North Africa) and others.ResultsIn total, 1,571 patients were identified. The incidence of PCS was observed to be rising and ranged from 6.3 to 13.2/100,000 adult population over the study period. Men were 82.4% of the total. The mean age was 54.9 ± 12.7 years (median 54 years, IQR 46, 63). MENA patients comprised 616 (39.2%) while others were 954 (60.7%); of these, the majority (80.5%) were from South Asia. Vascular risk factors were prevalent with 1,230 (78.3%) having hypertension, 970 (61.7%) with diabetes, and 872 (55.5%) having dyslipidemia. Weakness (944, 58.8%), dizziness (801, 50.5%), and slurred speech (584, 36.2%) were the most commonly presenting symptoms. The mean National Institute of Health Stroke Score (NIHSS) score was 3.8 ± 4.6 (median 3, IQR 1, 5). The overall most frequent stroke location was the distal location (568, 36.2%). The non-MENA cohort was younger, less vascularly burdened, and had more frequent proximal stroke location (p < 0.05). Dependency or death at discharge was seen in 39.5% and was associated with increasing age, and proximal and multilocation involvement; while at 90 days it was 27.4% and was associated with age, male sex, and having a MENA nationality (p < 0.05).ConclusionIn a multiethnic cohort of posterior circulation stroke patients from the MENA region and South Asia, we noted a rising incidence over time, high prevalence of vascular risk factors, and poor outcomes in older men from the MENA region. We also uncovered considerable disparities between the MENA and non-MENA groups in stroke location and outcome. These disparities are crucial factors to consider when tailoring individualized patient care plans. Further research is needed to thoroughly investigate the underlying reasons for these variations. |
| first_indexed | 2024-03-08T04:45:01Z |
| format | Article |
| id | doaj.art-ad5ebe591da34382a612c688508a2c2e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-08T04:45:01Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ad5ebe591da34382a612c688508a2c2e2024-02-08T11:07:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-02-011510.3389/fneur.2024.13022981302298Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke databaseYahia Z. Imam0Yahia Z. Imam1Yahia Z. Imam2Prem Chandra3Rajvir Singh4Ishrat Hakeem5Sally Al Sirhan6Mona Kotob7Naveed Akhtar8Naveed Akhtar9Naveed Akhtar10Saadat Kamran11Saadat Kamran12Salman Al Jerdi13Ahmad Muhammad14Ahmad Muhammad15Khawaja Hasan Haroon16Suhail Hussain17Jon D. Perkins18Osama Elalamy19Osama Elalamy20Mohamed Alhatou21Liaquat Ali22Mohamed S. Abdelmoneim23Sujatha Joseph24Deborah Morgan25Ryan Ty Uy26Zain Bhutta27Aftab Azad28Aftab Azad29Ali Ayyad30Ahmed Elsotouhy31Ahmed Own32Dirk Deleu33Dirk Deleu34Neuroscience Institute, Hamad Medical Corporation, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarCollege of Medicine, Qatar University, Doha, QatarStatistics, Medical Research Center, Hamad Medical Corporation, Doha, QatarCardiology Research Center, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarCollege of Medicine, Qatar University, Doha, QatarCollege of Medicine, Qatar University, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarCollege of Medicine, Qatar University, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, QatarCollege of Medicine, Qatar University, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarNeuroscience Institute, Hamad Medical Corporation, Doha, QatarWeill Cornell Medicine-Qatar, Doha, QatarBackgroundPosterior cerebral circulation ischemic stroke (PCS) comprises up to 25% of all strokes. It is characterized by variable presentation, leading to misdiagnosis and morbidity and mortality. We aim to describe PCS in large multiethnic cohorts.MethodsA retrospective review of a large national stroke database from its inception on the 1st of January 2014 till 31 December 2020. Incidence per 100,000 adult population/year, demographics, clinical features, stroke location, and outcomes were retrieved. We divided the cohort into patients from MENA (Middle East and North Africa) and others.ResultsIn total, 1,571 patients were identified. The incidence of PCS was observed to be rising and ranged from 6.3 to 13.2/100,000 adult population over the study period. Men were 82.4% of the total. The mean age was 54.9 ± 12.7 years (median 54 years, IQR 46, 63). MENA patients comprised 616 (39.2%) while others were 954 (60.7%); of these, the majority (80.5%) were from South Asia. Vascular risk factors were prevalent with 1,230 (78.3%) having hypertension, 970 (61.7%) with diabetes, and 872 (55.5%) having dyslipidemia. Weakness (944, 58.8%), dizziness (801, 50.5%), and slurred speech (584, 36.2%) were the most commonly presenting symptoms. The mean National Institute of Health Stroke Score (NIHSS) score was 3.8 ± 4.6 (median 3, IQR 1, 5). The overall most frequent stroke location was the distal location (568, 36.2%). The non-MENA cohort was younger, less vascularly burdened, and had more frequent proximal stroke location (p < 0.05). Dependency or death at discharge was seen in 39.5% and was associated with increasing age, and proximal and multilocation involvement; while at 90 days it was 27.4% and was associated with age, male sex, and having a MENA nationality (p < 0.05).ConclusionIn a multiethnic cohort of posterior circulation stroke patients from the MENA region and South Asia, we noted a rising incidence over time, high prevalence of vascular risk factors, and poor outcomes in older men from the MENA region. We also uncovered considerable disparities between the MENA and non-MENA groups in stroke location and outcome. These disparities are crucial factors to consider when tailoring individualized patient care plans. Further research is needed to thoroughly investigate the underlying reasons for these variations.https://www.frontiersin.org/articles/10.3389/fneur.2024.1302298/fullobservationalincidenceclinical featuresposterior circulation strokemultiethnicoutcomes |
| spellingShingle | Yahia Z. Imam Yahia Z. Imam Yahia Z. Imam Prem Chandra Rajvir Singh Ishrat Hakeem Sally Al Sirhan Mona Kotob Naveed Akhtar Naveed Akhtar Naveed Akhtar Saadat Kamran Saadat Kamran Salman Al Jerdi Ahmad Muhammad Ahmad Muhammad Khawaja Hasan Haroon Suhail Hussain Jon D. Perkins Osama Elalamy Osama Elalamy Mohamed Alhatou Liaquat Ali Mohamed S. Abdelmoneim Sujatha Joseph Deborah Morgan Ryan Ty Uy Zain Bhutta Aftab Azad Aftab Azad Ali Ayyad Ahmed Elsotouhy Ahmed Own Dirk Deleu Dirk Deleu Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database Frontiers in Neurology observational incidence clinical features posterior circulation stroke multiethnic outcomes |
| title | Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database |
| title_full | Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database |
| title_fullStr | Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database |
| title_full_unstemmed | Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database |
| title_short | Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database |
| title_sort | incidence clinical features and outcomes of posterior circulation ischemic stroke insights from a large multiethnic stroke database |
| topic | observational incidence clinical features posterior circulation stroke multiethnic outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1302298/full |
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