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Clinical characteristics of stroke among chinese patients
234A
ASH XV ABSTRACTS
of the country. Thus, in the southern United States, stroke morbidity remains a public health challenge for blacks and non-blacks that has yet to respond to ongoing preventive efforts. Key Words: Stroke; hospitalization; south; blacks D004 STROKE HOSPITALIZATION AND MORTALITY TREND (1979 –1997), UNITED STATES J. Fang, S. Madhavan, H. Cohen, M.H. Alderman*. Albert Einstein College of Medicine, New York Age-adjusted stroke mortality in the United States has declined in recent decades. However, there is little information about changes in morbidity. We have examined the National Hospital Discharge Survey data from 1979 to 1997 to determine stroke hospitalization. From 1979 to 1997, total noninstitutional hospitalization in the United States decreased from 36,746,563 to 30,914,167 (16%). At the same time, stroke (ICD-9 430 – 438) hospitalization increased by 36% (746,520 to 1,017,667). Thus, the percentage of stroke hospitalization increased by 65%, from 2.0% to 3.3%. The percentage of hospitalization accounted for by stroke defined as hemorrhagic and ischemic increased symmetrically from 6.5% to 11.2% and 26.6% to 49.5% respectively. Mortality among hospitalized stroke patients decreased from 13.5% to 6.3% (53%), but the percentage reduction was greater for ischemic (70.5%) than hemorrhagic (40.5%) stroke. Thus, over the past 20 pears, in the face of decreased overall hospitalization, the number of stroke hospitalization has increased by more than 1/3. Precision of diagnosis has sharply increased, but the proportion of hemorrhagic vs ischemic remains unchanged, as does the increased risk of death associated with hemorrhagic stroke. Thus, it appears that decreased case fatality, and not reduced incidence, account for declining stroke mortality in the US.
Key Words: Stroke; hospitalization; mortality D005 CLINICAL CHARACTERISTICS OF STROKE AMONG CHINESE PATIENTS S.H. Foo, J. Fang, J.S. Jeng, P.K. Yip, M.H. Alderman*. New York University Downtown Hospital, New York, NY, and Albert Einstein College of Medicine, Bronx, NY To compare the characteristics and experience of Chinese patients experiencing stroke with others in New York City, we have reviewed the medical records of stroke patients hospitalized at New York University Downtown hospital from January 1995 to July 1998. During three and half years, there were 843 stroke patients admitted (Chinese 499, whites
AJH–APRIL 2000 –VOL. 13, NO. 4, PART 2
153, blacks 88, Hispanics 99 and other Asia 4). Compared to other race/ethnic groups, Chinese stroke patients were older 71.5 vs 69.7 (whites), 62.6 (blacks), and 64.9 (Hispanics) p ⬍ 0.01); had lower body mass index (22.8 vs 26.1, 26.2 and 25.2 respectively) (p ⬍ 0.01), were less likely to smoke (11.8% vs 22.2%, 22.7 and 32.3%, p ⬍ 0.01), to regularly drink alcohol (7.8% vs 28.1%, 34.1% and 29.3%, p ⬍ 0.01). Chinese and blacks were more likely, and whites least likely, to have history of hypertension, untreated hypertension, and left ventricular hypertrophy. Compared with other race/ethnic groups, Chinese had the highest risk of hemorrhagic stroke (19.2% vs 12.4%, 12.5% and 11.1%). Overall hospital mortality was 12% with no significant difference between groups. Hemorrhagic stroke was more likely to be fatal than ischemic stroke (35.3% vs 7.0%, p ⬍ 0.001). However, Chinese patients had the lowest hospital death rates for both hemorrhagic and ischemic stroke, compared to whites, blacks and Hispanics (6.1% vs 9.5%, 8.1% and 7.6% for ischemic stroke, 31.3% vs 31.6%, 54.5% and 54.5% for hemorrhagic stroke, p ⬍ 0.05). Controlling for age and gender, the variables significantly predictive of hospital deaths for stroke (odds ratios and 95% confidence interval) are SBP (1.02, 1.01–1.03), blood sugar (1.01, 1.005–1.016), and hemorrhagic stroke (5.53, 1.96 –15.61). These associations were similar for all groups. Although Chinese stroke patients different in important ways from others, mortality rate did not, despite the fact that Chinese were more likely to experience the more lethal hemorrhagic than ischemic form of stroke. Key Words: Stroke; Chinese patients; clinical characteristics D006 LIPIDS AND FIBRINOGEN PLASMA LEVELS IN ISCHEMIC AND HEMORRHAGIC STROKE. OUR EXPERIENCE IN 2538 PATIENTS G.N. Ziakas, A.I. Hatzitolios, C.G. Savopoulos, A.D. Kounanis, J.P. Christoforidis, A.G. Ziakas. 1st Medical Prop. DeptAHEPA Hospital, Aristotelian University, Thessaloniki, Greece Purpose: Lipids and fibrinogen plasma levels have already been considered as independent risk factors for stroke. In this study we compared these factors in patients with ischemic and hemorrhagic stroke. Design and method: we studied 2538 patients in a period of 6 years (1993–1999). 2380 with ischemic stroke (1131 male and 1249 female patients with mean age 73,16 ⫾ 8,86 years ) and 156 with hemorrhagic stroke (72 male and 84 female patients with mean age 71,12 ⫾ 7,33 years). Plasma levels of cholesterol, triglycerides, HDL and fibrinogen were determined and the analysis was made using t-test for means. The results (mean ⫾ SD ) were as follows: Conclusions: a: the statistical analysis indicated significant relation between plasma cholesterol levels and ischemic stroke, while these levels seem to be lower in patients with hemorrhagic stroke. b: there was also significant relation between plasma triglycerides levels and ischemic stroke. c: no significant difference was observed in HDL and fibrinogen levels among patients with ischemic or hemorrhagic stroke.
ASH XV ABSTRACTS
of the country. Thus, in the southern United States, stroke morbidity remains a public health challenge for blacks and non-blacks that has yet to respond to ongoing preventive efforts. Key Words: Stroke; hospitalization; south; blacks D004 STROKE HOSPITALIZATION AND MORTALITY TREND (1979 –1997), UNITED STATES J. Fang, S. Madhavan, H. Cohen, M.H. Alderman*. Albert Einstein College of Medicine, New York Age-adjusted stroke mortality in the United States has declined in recent decades. However, there is little information about changes in morbidity. We have examined the National Hospital Discharge Survey data from 1979 to 1997 to determine stroke hospitalization. From 1979 to 1997, total noninstitutional hospitalization in the United States decreased from 36,746,563 to 30,914,167 (16%). At the same time, stroke (ICD-9 430 – 438) hospitalization increased by 36% (746,520 to 1,017,667). Thus, the percentage of stroke hospitalization increased by 65%, from 2.0% to 3.3%. The percentage of hospitalization accounted for by stroke defined as hemorrhagic and ischemic increased symmetrically from 6.5% to 11.2% and 26.6% to 49.5% respectively. Mortality among hospitalized stroke patients decreased from 13.5% to 6.3% (53%), but the percentage reduction was greater for ischemic (70.5%) than hemorrhagic (40.5%) stroke. Thus, over the past 20 pears, in the face of decreased overall hospitalization, the number of stroke hospitalization has increased by more than 1/3. Precision of diagnosis has sharply increased, but the proportion of hemorrhagic vs ischemic remains unchanged, as does the increased risk of death associated with hemorrhagic stroke. Thus, it appears that decreased case fatality, and not reduced incidence, account for declining stroke mortality in the US.
Key Words: Stroke; hospitalization; mortality D005 CLINICAL CHARACTERISTICS OF STROKE AMONG CHINESE PATIENTS S.H. Foo, J. Fang, J.S. Jeng, P.K. Yip, M.H. Alderman*. New York University Downtown Hospital, New York, NY, and Albert Einstein College of Medicine, Bronx, NY To compare the characteristics and experience of Chinese patients experiencing stroke with others in New York City, we have reviewed the medical records of stroke patients hospitalized at New York University Downtown hospital from January 1995 to July 1998. During three and half years, there were 843 stroke patients admitted (Chinese 499, whites
AJH–APRIL 2000 –VOL. 13, NO. 4, PART 2
153, blacks 88, Hispanics 99 and other Asia 4). Compared to other race/ethnic groups, Chinese stroke patients were older 71.5 vs 69.7 (whites), 62.6 (blacks), and 64.9 (Hispanics) p ⬍ 0.01); had lower body mass index (22.8 vs 26.1, 26.2 and 25.2 respectively) (p ⬍ 0.01), were less likely to smoke (11.8% vs 22.2%, 22.7 and 32.3%, p ⬍ 0.01), to regularly drink alcohol (7.8% vs 28.1%, 34.1% and 29.3%, p ⬍ 0.01). Chinese and blacks were more likely, and whites least likely, to have history of hypertension, untreated hypertension, and left ventricular hypertrophy. Compared with other race/ethnic groups, Chinese had the highest risk of hemorrhagic stroke (19.2% vs 12.4%, 12.5% and 11.1%). Overall hospital mortality was 12% with no significant difference between groups. Hemorrhagic stroke was more likely to be fatal than ischemic stroke (35.3% vs 7.0%, p ⬍ 0.001). However, Chinese patients had the lowest hospital death rates for both hemorrhagic and ischemic stroke, compared to whites, blacks and Hispanics (6.1% vs 9.5%, 8.1% and 7.6% for ischemic stroke, 31.3% vs 31.6%, 54.5% and 54.5% for hemorrhagic stroke, p ⬍ 0.05). Controlling for age and gender, the variables significantly predictive of hospital deaths for stroke (odds ratios and 95% confidence interval) are SBP (1.02, 1.01–1.03), blood sugar (1.01, 1.005–1.016), and hemorrhagic stroke (5.53, 1.96 –15.61). These associations were similar for all groups. Although Chinese stroke patients different in important ways from others, mortality rate did not, despite the fact that Chinese were more likely to experience the more lethal hemorrhagic than ischemic form of stroke. Key Words: Stroke; Chinese patients; clinical characteristics D006 LIPIDS AND FIBRINOGEN PLASMA LEVELS IN ISCHEMIC AND HEMORRHAGIC STROKE. OUR EXPERIENCE IN 2538 PATIENTS G.N. Ziakas, A.I. Hatzitolios, C.G. Savopoulos, A.D. Kounanis, J.P. Christoforidis, A.G. Ziakas. 1st Medical Prop. DeptAHEPA Hospital, Aristotelian University, Thessaloniki, Greece Purpose: Lipids and fibrinogen plasma levels have already been considered as independent risk factors for stroke. In this study we compared these factors in patients with ischemic and hemorrhagic stroke. Design and method: we studied 2538 patients in a period of 6 years (1993–1999). 2380 with ischemic stroke (1131 male and 1249 female patients with mean age 73,16 ⫾ 8,86 years ) and 156 with hemorrhagic stroke (72 male and 84 female patients with mean age 71,12 ⫾ 7,33 years). Plasma levels of cholesterol, triglycerides, HDL and fibrinogen were determined and the analysis was made using t-test for means. The results (mean ⫾ SD ) were as follows: Conclusions: a: the statistical analysis indicated significant relation between plasma cholesterol levels and ischemic stroke, while these levels seem to be lower in patients with hemorrhagic stroke. b: there was also significant relation between plasma triglycerides levels and ischemic stroke. c: no significant difference was observed in HDL and fibrinogen levels among patients with ischemic or hemorrhagic stroke.