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Stroke Care Systems in Asia
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THE PHILIPPINE NEUROLOGICAL ASSOCIATION ONE DATABASE - STROKE (PNA1DB-STROKE): FIRST YEAR PRIMARY RESULTS
Abstract
Background and Aims
Systematic data on TIA/stroke in the Philippines is scarce. We aimed to prospectively collect uniform data among patients hospitalized with TIA or stroke.
Methods
All patients admitted at 11 neurology training hospitals are included if they are >/=18 years old and diagnosed with TIA, ischemic or hemorrhagic stroke, or cerebral venous thrombosis. Patients admitted primarily for non-acute stroke-related sequelae/procedures, e.g., infection, gastric tube insertion, are excluded. Anonymized data on socio-demographics, medical history, stroke subtype, in-hospital management and discharge outcomes are entered in a secure online data collection tool. Clinicaltrials.gov NCT04972058.
Results
| TIA/Ischemic | ICH | SAH | |
|---|---|---|---|
| N | 69/1017 | 617 | 96 |
| Age (years) Female Asian | 60.7+/-13.8 489 (45.0%) 1065 (98.1%) | 53.8+/-13.0 228 (37.0%) 603 (97.7%) | 56.7+/-13.5 59 (61.5%) 92 (95.8%) |
| Recurrent event | 79(7.3%) | 22(3.6%) | 1(1.0%) |
| Hypertension Diabetes mellitus Dyslipidemia Atrial fibrillation Valvular heart disesse Other heart disease Smoker Heavy alcohol use | 801(73.8%) 277(25.5%) 213(19.6%) 94(8.7%) 20(1.8%) 83(7.6%) 269(24.8%) 162(14.9%) | 453(73.4%) 70(11.3%) 49(7.9%) 11(1.8%) 4(0.6%) 10(1.6%) 220(35.7%) 176(28.5%) | 63(65.6%) 8(8.3%) 6(6.3%) 0 0 4(4.2%) 16(16.7%) 15(15.6%) |
| Transferred from another hospital | 174(16.0%) | 147(23.8%) | 31(32.3%) |
| Among non-transferees: Stroke-onset to hospital arrival </=6 hours Revascularization | . 189(32.5%) 59(6.6%) | . 206(45.1%) | . 26(41.3%) |
| SARS-CoV-2+ | 98(9.0%) | 36(5.8%) | 6(6.3%) |
| mRS at discharge: 0-3 4-5 6/dead No data | 813(74.9%) 126(11.6%) 109(10.0%) 38(3.5%) | 302(48.9%) 108(17.5%) 160(25.9%) 47(7.6%) | 41(42.7%) 12(12.5%) 35(36.5%) 8(8.3%) |
Conclusions
TIA/stroke admissions in PNA1DB-Stroke hospitals reduced significantly during the pandemic (previous census 10,000-14,000/year) with low revascularization rate. Case-fatality was highest among hemorrhagic strokes (27%). Data collection will continue further for 3 years.