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Journal articles on the topic 'Stroke register'

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Published: 3 June 2025

Last updated: 13 July 2025

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Tilling, Kate, Jonathan AC Sterne, and Charles DA Wolfe. "Estimating incidence of stroke using capture-recapture models." Circulation 103, suppl_1 (2001): 1361. http://dx.doi.org/10.1161/circ.103.suppl_1.9998-57.

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P57 Background:Incidence of stroke (and other cardiovascular diseases) is often estimated using population-based registers. No register is 100% complete, and cases missed may differ from those registered, for example by having less severe disease. Failure to estimate the number of cases missed will lead to under-estimation of the true incidence of disease. Comparisons between areas, or examination of trends over time, will also be biased if the probability of being registered varies between them. Methods: Recently developed capture-recapture models including covariates were used to estimate incidence of stroke using data from a population-based register in South London, UK. The model parameters were used to estimate ascertainment-adjusted age-standardised incidence rates. Confidence intervals which allow for the uncertainty in the estimation of population size were calculated. Results:The crude capture-recapture model (not including covariates) under-estimated the number of non-fatal strokes. Probability of capture by the register was associated with both demographic variables and stroke-severity indicators. A capture-recapture model including these covariates led to more plausible estimates of the numbers of both fatal and non-fatal strokes, and suggested that the stroke register was approximately 88% complete. Adjusting for the number of cases missed increased the estimated incidence from 1.31 (95% confidence interval 1.21 to 1.42)to 1.49 (95% confidence interval 0.38 to 2.60) per 1,000 people. Conclusions: Using these methods, data from an incomplete register can be used to calculate both incidence and age-standardised incidence. However, sparse data in subgroups can lead to wide confidence intervals for adjusted rates. Routine registers might be made more cost-effective by using the combination of sources and covariates which most accurately estimates the population size, instead of aiming for 100% completeness. Comparisons of incidence between registers should be based on rates which are adjusted for the number and type of cases missed.

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Söderholm, Anna, Birgitta Stegmayr, Eva-Lotta Glader, and Kjell Asplund. "Validation of Hospital Performance Measures of Acute Stroke Care Quality. Riksstroke, the Swedish Stroke Register." Neuroepidemiology 46, no. 4 (2016): 229–34. http://dx.doi.org/10.1159/000444679.

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Background: Registers are increasingly used to monitor stroke care performance. Fair benchmarking requires sufficient data quality. We have validated acute care data in Riksstroke, the Swedish Stroke Register. Methods: Completeness was assessed by comparisons with diagnoses at hospital discharge recorded in the compulsory National Patient Register and content validity by comparisons with (a) key variables identified by European stroke experts, and (b) items recorded in other European stroke care performance registers. Five test cases recorded by 67 hospitals were used to estimate inter-hospital reliability. Results: All 72 Swedish hospitals admitting acute stroke patients participated in Riksstroke. The register was estimated to cover at least 90% of acute stroke patients. It includes 18 of 22 quality indicators identified by international stroke experts and 14 of 15 indicators used by at least 2 stroke performance registers in other European countries. Inter-hospital reliability was high (≥85%) in 77 of 81 Riksstroke items. Conclusions: A nationwide stroke care register can be maintained with sufficient data quality to permit between-hospital performance benchmarking. Our experiences may serve as a model for other stroke registers while evaluating data quality.

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Tuomilehto, Jaakko, Cinzia Sarti, Erkki V. Narva, et al. "The FINMONICA Stroke Register." American Journal of Epidemiology 135, no. 11 (1992): 1259–70. http://dx.doi.org/10.1093/oxfordjournals.aje.a116232.

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Alfimova, G. Yu, and N. N. Maslova. "Stroke register in Smolensk Region." Bulletin of Siberian Medicine 7, no. 5-1 (2008): 19–22. http://dx.doi.org/10.20538/1682-0363-2008-5-1-19-22.

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The stroke register having been started in Smolensk Region revealed stroke morbidity 2,38 cases and stroke mortality 1,25 cases for 1000 people in 2007. Stroke-case fatality comprised 33,4%. Hypertension appeared to be the main risk factor of stroke (81%).

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Kilichev, I. A., M. O. Matyokubov, Z. I. Adambaev, N. Yu Khudayberganov, and N. S. Mirzaeva. "Register of stroke in the desert-steppe zones of Uzbekistan." BIO Web of Conferences 65 (2023): 04002. http://dx.doi.org/10.1051/bioconf/20236504002.

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Purpose of the study: to conduct a register of stroke in the desert-steppe zones of Uzbekistan on the example of the Khorezm region and to identify the influence of a complex of weather-climatic factors on the course and outcomes of cerebral strokes. To determine the prognosis of cerebral strokes in the near future, a “Register of cerebral strokes” was conducted in the desert-steppe zones of Uzbekistan – using the example of the Khorezm region for 2019. The conducted register of strokes in 2019 in the desert-steppe zones of Uzbekistan revealed 3569 cases of stroke, of which 1967 (55.1%) in men and 1602 (44.9%) in women. The population aged 20 years and older was 1,150,135 people, of which 565,722 men (49.2%) and 584,413 women (50.8%). The mean age of patients with stroke was 63.85±0.2 years, in men - 62.9±0.3 years, in women - 65.1±0.3 years. The incidence of cerebral strokes corresponded to 194.43 cases per 100,000 population. The incidence of cerebral strokes at the age of 20 and older was 310.32 cases per 100,000 populationThe main risk factors for stroke are: arterial hypertension (62.3%), atherosclerosis (19.5%), coronary heart disease (7.5%), diabetes mellitus (3.8%). Seasonality of strokes in the region - ischemic and hemorrhagic strokes prevailed in winter (28.1% and 29.7%) and spring (31.7% and 25.0%) months, respectively. Subarachnoid hemorrhages prevailed in summer (36.8%) months. In winter and spring, the “spastic” type of heart is a provoking meteorological risk factor for the development of ischemic and hemorrhagic strokes. In summer - “hypoxic”, and in autumn - “unstable weather with the transition from indifferent to” spastic “weather types are provoking meteorological factors for the development of subarachnoid hemorrhages.

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Hofer, Christine, Stefan Kiechl, and Wilfried Lang. "Das österreichische Stroke-Unit-Register." Wiener Medizinische Wochenschrift 158, no. 15-16 (2008): 411–17. http://dx.doi.org/10.1007/s10354-008-0563-6.

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Truelsen, Thomas. "Experiences from the Mumbai Stroke Register." Neuroepidemiology 31, no. 4 (2008): 262–63. http://dx.doi.org/10.1159/000165365.

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Arkema, Elizabeth V., Elisabet Svenungsson, Mia Von Euler, Christopher Sjöwall, and Julia F. Simard. "Stroke in systemic lupus erythematosus: a Swedish population-based cohort study." Annals of the Rheumatic Diseases 76, no. 9 (2017): 1544–49. http://dx.doi.org/10.1136/annrheumdis-2016-210973.

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ObjectiveTo study the occurrence of ischaemic and haemorrhagic stroke in systemic lupus erythematosus (SLE) compared with the general population by age, sex and time since SLE diagnosisMethodsAdults with incident SLE were identified from the Swedish National Patient Register (NPR, n=3390) and general population comparators from the Total Population Register were matched on age, sex and county (n=16730). Individuals were followed prospectively until first of death, December 2013, emigration or incident stroke (identified from the NPR, Cause of Death Register and the Stroke Register). Incidence rates, rate differences and HR were estimated comparing SLE with non-SLE. Estimates were stratified by sex, age and time since diagnosis.ResultsWe observed 126 strokes in SLE and 304 in the general population. Individuals with SLE had a twofold increased rate of ischaemic stroke compared with the general population (HR 2.2; 95% CI 1.7 to 2.8). The HR for intracerebral haemorrhage was 1.4 (95% CI 0.7 to 2.8). There was effect modification by sex and age, with the highest HRs for females and individuals <50 years old. The HR for ischaemic stroke was highest in the first year of follow-up (3.7; 95% CI 2.1 to 6.5).ConclusionsThe relative risk of ischaemic stroke in SLE was more than doubled compared with the general population, and importantly, the highest relative risks were observed within the first year after SLE diagnosis. Thus, the first encounter with patients presents an opportunity for rheumatologists to screen for risk factors and intervene.

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Alonso, de Leciñana María, Michael V. Mayza, Nikolaos Kostoulas, et al. "Stroke Care and Application of Thrombolysis in Ibero-America: Report From the SITS-SIECV Ibero-American Stroke Register." Stroke 50, no. 9 (2019): 2507–12. https://doi.org/10.1161/STROKEAHA.119.025668.

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Background and purpose: Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement. Methods: Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September 2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time, National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality, and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis. Results: Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%) ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%), dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected (median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients. Conclusions: Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.

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Turgumbaev, D. D. "EPIDEMIOLOGY OF STROKE IN BISHKEK ACCORDING TO THE REGISTER." National Journal of Neurology 2, no. 17 (2017): 47–51. http://dx.doi.org/10.61788/njn.v2i17.07.

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Using a register approach, an epidemiologic survey of stroke in Kyrgyzstan (Bishkek) was conducted according to a program specially worked out. A total sample studied included 567218 subjects. Overall, 3200 new cases of acute blood supply disturbances were registered for a two- year period. Stroke morbidity was found to reach 2.82 per 1000 persons, mortality rate – 1.18, lethality – 41.8%. 42.4% patients were admitted to the hospital, in these cases mortality was 25,7%, while that in patients with stroke were treated –53.6%. It is concluded that a longitudinal register for obtaining data on mortality dynamics and evaluation of efficacy of improved medico- social care programs is needed.

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Asplund, Kjell, Kerstin Hulter Åsberg, Bo Norrving, Birgitta Stegmayr, and Andreas Terént. "Riks-Stroke – A Swedish National Quality Register for Stroke Care." Cerebrovascular Diseases 15, no. 1 (2003): 5–7. http://dx.doi.org/10.1159/000068203.

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Thomas, Brenda, Alison McInnes, and Peter Sandercock. "Contribution of Stroke to the Cochrane Stroke Group Trials Register." Stroke 34, no. 2 (2003): 374–78. http://dx.doi.org/10.1161/01.str.0000053473.88810.37.

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Hagberg, Guri, Haakon Ihle-Hansen, Tamar Abzhandadze, Malin Reinholdsson, Hege Ihle Hansen, and Katharina S. Sunnerhagen. "Prognostic value of acute National Institutes of Health Stroke Scale Items on disability: a registry study of first-ever stroke in the western part of Sweden." BMJ Open 13, no. 12 (2023): e080007. http://dx.doi.org/10.1136/bmjopen-2023-080007.

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ObjectivesWe aimed to study how the individual items of the National Institutes of Health Stroke Scale (NIHSS) at admission predict functional independence 3 months post-stroke in patients with first-ever stroke.SettingThis registry-based study used data from two Swedish stroke registers (Riksstroke, the mandatory national quality register for stroke care in Sweden, and Väststroke, a local quality stroke register in Gothenburg).ParticipantsThis study included patients with first-ever acute stroke admitted from November 2014 to August 2018, with available NIHSS at admission and modified Rankin Scale (mRS) at 3-month follow-up.Primary outcomeThe primary outcome variable was mRS≤1 (defined as an excellent outcome) at 3-month follow-up.ResultsWe included 1471 patients, mean age was 72 (± 14.5) years, 48% were female, and 66% had mild strokes (NIHSS≤3). In adjusted binary logistic regression analysis, the NIHSS items impaired right motor arm and leg, and impairment in visual field, reduced the odds of an excellent outcome at 3 months ((OR 0.60 (95% CI 0.37 to 0.98), OR 0.60 (95% CI 0.37 to 0.97), and OR 0.65 (95% CI 0.45 to 0.94)). When exploring the effect size of associations between NIHSS items and mRS≤1 p, orientation, language and right leg motor had the largest yet small association.ConclusionsStroke patients with scores on the NIHSS items right motor symptoms or visual field at admission are less likely to have an excellent outcome at 3 months. Clinicians should consider the NIHSS items affected, not only the total NIHSS score, both in treatment guidance and prognostics.

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Alifirova, V. M., O. M. Antukhova, and T. Ye Vinogradova. "Stroke register in Seversk: the first results." Bulletin of Siberian Medicine 4, no. 3 (2005): 81–86. http://dx.doi.org/10.20538/1682-0363-2005-3-81-86.

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Marshall, Iain J., Charles Wolfe, Eva Emmett, et al. "Cohort profile: The South London Stroke Register – a population-based register measuring the incidence and outcomes of stroke." Journal of Stroke and Cerebrovascular Diseases 32, no. 8 (2023): 107210. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2023.107210.

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Cappellari, Manuel, Gianni Turcato, Stefano Forlivesi, et al. "The START nomogram for individualized prediction of the probability of unfavorable outcome after intravenous thrombolysis for stroke." International Journal of Stroke 13, no. 7 (2018): 700–706. http://dx.doi.org/10.1177/1747493018765490.

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Background and purpose The nomogram is an important component of modern medical decision-making, which calculates the probability of an event entirely based on individual characteristics. We aimed to develop and validate a nomogram for individualized prediction of the probability of unfavorable outcome in intravenous thrombolysis-treated stroke patients included in the large multicenter Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. Methods All patients registered in the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register by 179 Italian centers between May 2001 and March 2016 were originally included. The main outcome measure was three-month unfavorable outcome (modified Rankin Scale 3–6). Four non-categorical predictors of unfavorable outcome (baseline National Institutes of Health (NIH) Stroke Scale score: 0–25, age ≥18 years, pre-stroke modified Rankin Scale score: 0–2, and onset-to-treatment time: 0–270 min) were identified a-priori by three neurologists with expertise in the management of stroke. To generate the NIHSS STroke Scale score, Age, pre-stroke mRS score, onset-to-treatment Time (START), the pre-established predictors were entered into a logistic regression model. The discriminative performance of the model was assessed using the area under the receiver operating characteristic curve. Results A total of 15,862 patients with complete data for generating the START was randomly dichotomized into training (2/3, n = 10,574) and test (1/3, n = 5288) sets. The area under the receiver operating characteristic curve of START was 0.800 (95% confidence interval: 0.792–0.809) in the training set and 0.815 (95% confidence interval: 0.804–0.822) in the test set. Conclusions By using a limited number of non-categorical predictors, the START is the first nomogram developed and validated in a large Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register cohort, which reliably calculates the probability of unfavorable outcome in intravenous thrombolysis-treated stroke patients.

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Voevoda, M. I., Yu V. Skurikhina, and S. V. Shishkin. "Assoclation polymorphism apoe gene and blood lipid profile with diffe different types of stroke in Siberia." Bulletin of Siberian Medicine 10, no. 2 (2011): 104–9. http://dx.doi.org/10.20538/1682-0363-2011-2-104-109.

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The present research aimed at studying association between Apo E polymorphism and certain types of stroke and also association factors of lipid profile’s results and different types of stroke it depends on sex and conditions of living in typical West Siberian megapolis (Novosibirsk).The causes of brain stroke were registered in representative population with population about 150 000 in according to standarts of WHO program MONICA and previous program «Register of stroke». From 2003 to 2007 among new registered and repeated causes of stroke was form at random 15% sample (261 patients). The average age of stroke attack is 61,3 ± 1,0 for men and 61,3 ± 1,0 for women.Independent influence of APOE gene's genotypes polymorphism on development at different stroke patients has not been revealed.

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Butler, Jo, and Paula Jayne Bourke. "Diabetes and stroke in Qatar: results of a prospective stroke register." International Diabetes Nursing 12, no. 2 (2015): 63–68. http://dx.doi.org/10.1179/2057332415y.0000000003.

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Ilinca, A., U. Kristoffersson, M. Soller, and A. G. Lindgren. "Familial aggregation of stroke amongst young patients in Lund Stroke Register." European Journal of Neurology 23, no. 2 (2015): 401–7. http://dx.doi.org/10.1111/ene.12881.

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Stewart, J. A., R. Dundas, R. S. Howard, A. G. Rudd, and C. D. A. Wolfe. "Ethnic differences in incidence of stroke: prospective study with stroke register." BMJ 318, no. 7189 (1999): 967–71. http://dx.doi.org/10.1136/bmj.318.7189.967.

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Lühdorf, Pernille, Kim Overvad, Erik B. Schmidt, Søren P. Johnsen, and Flemming W. Bach. "Predictive value of stroke discharge diagnoses in the Danish National Patient Register." Scandinavian Journal of Public Health 45, no. 6 (2017): 630–36. http://dx.doi.org/10.1177/1403494817716582.

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Aims: To determine the positive predictive values for stroke discharge diagnoses, including subarachnoidal haemorrhage, intracerebral haemorrhage and cerebral infarction in the Danish National Patient Register. Methods: Participants in the Danish cohort study Diet, Cancer and Health with a stroke discharge diagnosis in the National Patient Register between 1993 and 2009 were identified and their medical records were retrieved for validation of the diagnoses. Results: A total of 3326 records of possible cases of stroke were reviewed. The overall positive predictive value for stroke was 69.3% (95% confidence interval (CI) 67.8–70.9%). The predictive values differed according to hospital characteristics, with the highest predictive value of 87.8% (95% CI 85.5–90.1%) found in departments of neurology and the lowest predictive value of 43.0% (95% CI 37.6–48.5%) found in outpatient clinics. Conclusions: The overall stroke diagnosis in the Danish National Patient Register had a limited predictive value. We therefore recommend the critical use of non-validated register data for research on stroke. The possibility of optimising the predictive values based on more advanced algorithms should be considered.

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Lindmark, Anita, Eva-Lotta Glader, Kjell Asplund, Bo Norrving, and Marie Eriksson. "Socioeconomic Disparities in Stroke Case Fatality – Observations from Riks-Stroke, the Swedish Stroke Register." International Journal of Stroke 9, no. 4 (2013): 429–36. http://dx.doi.org/10.1111/ijs.12133.

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Lindmark, Anita, Marie Eriksson, and David Darehed. "Socioeconomic status and stroke severity: Understanding indirect effects via risk factors and stroke prevention using innovative statistical methods for mediation analysis." PLOS ONE 17, no. 6 (2022): e0270533. http://dx.doi.org/10.1371/journal.pone.0270533.

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Background Those with low socioeconomic status have an increased risk of stroke, more severe strokes, reduced access to treatment, and more adverse outcomes after stroke. The question is why these differences are present. In this study we investigate to which extent the association between low socioeconomic status and stroke severity can be explained by differences in risk factors and stroke prevention drugs. Methods The study included 86 316 patients registered with an ischemic stroke in the Swedish Stroke Register (Riksstroke) 2012–2016. Data on socioeconomic status was retrieved from the Longitudinal integrated database for health insurance and labour market studies (LISA) by individual linkage. We used education level as proxy for socioeconomic status, with primary school education classified as low education. Stroke severity was measured using the Reaction Level Scale, with values above 1 classified as severe strokes. To investigate the pathways via risk factors and stroke prevention drugs we performed a mediation analysis estimating indirect and direct effects. Results Low education was associated with an excess risk of a severe stroke compared to mid/high education (absolute risk difference 1.4%, 95% CI: 1.0%-1.8%), adjusting for confounders. Of this association 28.5% was an indirect effect via risk factors (absolute risk difference 0.4%, 95% CI: 0.3%-0.5%), while the indirect effect via stroke prevention drugs was negligible. Conclusion Almost one third of the association between low education and severe stroke was explained by risk factors, and clinical effort should be taken to reduce these risk factors to decrease stroke severity among those with low socioeconomic status.

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Klochikhina, O. A., V. V. Shprakh, L. V. Stakhovskaya, and E. A. Polunina. "Prevalence of recurrent stroke in different age groups." Siberian Medical Review, no. 6 (2020): 51–56. http://dx.doi.org/10.20333/2500136-2020-6-51-56.

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The aim of the research is to study and to analyze the prevalence of recurrent strokes in the Russian regions included in Federal program from 2009 to 2016 on reorganization of care for patients with stroke in different age groups. Material and methods. The research method is territory and population register. The study included seven territories with 7124 of cases of recurrent stroke in total. The examined patients were divided into four age groups: of young age - 25-44 years old; of average age - 45-59 years old; of old age - 60-74 years old, and of senile - 75 years and older. Statistical analysis was carried out using programming language for statistical calculations R version 3.3.2. Results. The maximum number of recurrent stroke cases was registered in old age (46.6%), and the minimum number of cases of recurrent stroke was among young people (2.4%). When analyzing the incidence of recurrent strokes, depending on the year, the most systematic percentage decrease of recurrent strokes was observed among elderly people. The highest percentage of recurrent strokes was determined among the elderly people in 2013 - 26.38%; and the lowest percentage of recurrent strokes was recorded among young people. Conclusion. Among the surveyed age groups statistically significant decrease in recurrent strokes among young, middle-aged and elderly people was revealed during 2009 - 2016. It is the criterion for the effectiveness of recurrent stroke prevention conducted in the studied areas. There was no statistically significant decrease in the prevalence of recurrent stroke among elderly people by 2016. It indicates that the prevention of recurrent strokes in old age is a difficult task due to concomitant diseases and associated pathology in these patients.

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Subic, Ana, Eva Zupanic, Mia von Euler, et al. "Stroke as a Cause of Death in Death Certificates of Patients with Dementia: A Cohort Study from the Swedish Dementia Registry." Current Alzheimer Research 15, no. 14 (2018): 1322–30. http://dx.doi.org/10.2174/1567205015666181002134155.

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Introduction: Patients with dementia may be at a higher risk for death from stroke. We aimed to describe characteristics of dementia patients that died from ischemic stroke (IS) in Sweden. Methods: A retrospective longitudinal analysis of prospectively collected data of patients registered into the Swedish Dementia Registry was conducted. Data on causes of death, drugs and comorbidities were acquired from the Swedish nationwide health registers. Deaths were attributed to stroke if the death certificate contained stroke as a cause of death and the patient had a stroke registered in Riksstroke, the Swedish Stroke Register, in the year preceding death. Demographic data at the time of dementia diagnosis was compared between patients dying from IS and registered in Riksstroke, patients dying from IS without being registered in Riksstroke and those dying from other causes. Results: Out of 49823 patients diagnosed with dementia between 2007 and 2014 in primary care or specialist clinics, 14170 (28.4%) had died by the end of 2014. Of these 1180 (8.3%) had IS in their death certificate, of which 459 (38.9%) had been registered in Riksstroke. In patients who died of IS the most common type of dementia was vascular dementia while those died from other causes were most often diagnosed with Alzheimer’s dementia (AD). Patients who died from IS and were registered in Riksstroke had higher MMSE score compared to other groups. Patients who died from IS took more cardiovascular medications. There were no differences in the use of antipsychotics, antidepressants, acetylcholinesterase inhibitors, memantine, anxiolytics, or hypnotics between the groups. Conclusions: There was a relatively high number of patients who died from IS as shown in their death certificate but had not been registered in Riksstroke in the year before death. This creates concerns on the accuracy of death certificate stroke diagnoses, particularly for deaths taking place outside hospitals.

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Meehan, Edward F., Eugene Sobel, Milton Alter, Mildred E. Francis, Robert L. McCoy, and Lawrence P. Levitt. "The Lehigh Valley Stroke Program: Establishing a Communitywide, Hospital-Based Stroke Register." American Journal of Preventive Medicine 2, no. 2 (1986): 97–102. http://dx.doi.org/10.1016/s0749-3797(18)31355-2.

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Zelano, Johan, David Larsson, Eva Kumlien, and Signild Åsberg. "Pre-stroke seizures: A nationwide register-based investigation." Seizure 49 (July 2017): 25–29. http://dx.doi.org/10.1016/j.seizure.2017.05.010.

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Giampaoli, Simona, Niklas Hammarb, Roza Adany, and Christine De Peretti. "Population-based register of stroke: manual of operations." European Journal of Cardiovascular Prevention & Rehabilitation 14, no. 3_suppl (2007): S23—S41. http://dx.doi.org/10.1097/01.hjr.0000277987.10473.6f.

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Lekander, Ingrid, Carl Willers, Elisabeth Ekstrand, et al. "Hospital comparison of stroke care in Sweden: a register-based study." BMJ Open 7, no. 9 (2017): e015244. http://dx.doi.org/10.1136/bmjopen-2016-015244.

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Background and purposeThe objective of this study was to estimate the level of health outcomes and resource use at a hospital level during the first year after a stroke, and to identify any potential differences between hospitals after adjusting for patient characteristics (case mix).MethodData from several registries were linked on individual level: seven regional patient administrative systems, Swedish Stroke Register, Statistics Sweden, National Board of Health and Welfare and Swedish Social Insurance Agency. The study population consisted of 14 125 patients presenting with a stroke during 2010. Case-mix adjusted analysis of hospital differences was made on five aspects of health outcomes and resource use, 1 year post-stroke.ResultsThe results indicated that 26% of patients had died within a year of their stroke. Among those who survived, almost 5% had a recurrent stroke and 40% were left with a disability. On average, the patients had 22 inpatient days and 23 outpatient visits, and 13% had moved into special housing. There were significant variations between hospitals in levels of health outcomes achieved and resources used after adjusting for case mix.ConclusionDifferences in health outcomes and resource use between hospitals were substantial and not entirely explained by differences in patient mix, indicating tendencies of unequal stroke care in Sweden. Healthcare organisation of regions and other structural features could potentially explain parts of the differences identified.

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Jönsson, Ann-Cathrin, Ingrid Lindgren, Hossein Delavaran, Bo Norrving, and Arne Lindgren. "Falls After Stroke: A Follow-up after Ten Years in Lund Stroke Register." Journal of Stroke and Cerebrovascular Diseases 30, no. 6 (2021): 105770. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105770.

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Keselman, B., C. Cooray, G. Vanhooren, et al. "Intravenous thrombolysis in stroke mimics: results from the SITS International Stroke Thrombolysis Register." European Journal of Neurology 26, no. 8 (2019): 1091–97. http://dx.doi.org/10.1111/ene.13944.

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Petryaykina, E. E., I. O. Shchederkina, I. P. Vitkovskaya, et al. "Primary pediatric stroke center in the multidisciplinary pediatric hospital. New reality in pediatrics." City Healthcare 1, no. 1 (2020): 15–30. http://dx.doi.org/10.47619/2713-2617.zm.2020.v1i1;15-30.

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Background. The increase in the number of diagnosed strokes in children, significant distinctive features and complexity of diagnosis, treatment and prevention of cerebrovascular diseases in children compared with adults, the impossibility of direct extrapolation of therapeutic recommendations from adult practice to pediatrics required the creation of specialized primary centers of pediatric stroke in Russia. Purpose. The purpose of this article is to describe the experience of organizing a Center for the treatment of children and adolescents with cerebrovascular diseases (hereinafter referred to as the Center) on the basis of the multidisciplinary pediatric hospital of the Morozovskaya Children's City Clinical Hospital of Moscow Healthcare Department, the introduction of modern methods of diagnosis and treatment of strokes in pediatrics, the organization of preventive measures, maintaining the city register of children's stroke, coordinating the provision of medical care to children with cerebrovascular diseases at various levels in the city of Moscow. Materials and methods. The presented experience of organizing and operating the Center covers the period from 2014 to 2019. Researchers used descriptive, statistical, and comparative analysis to demonstrate the Center's performance and justify proposed improvements in diagnostics, management of pediatric patients with cerebrovascular disease, and relapse prevention. Results. In the course of the organization and operation of the Center, there was assessed the frequency of children's strokes in the city: in 2015 - 6.59 cases per 100 thousand of the child population of Moscow; in 2016 - 6.51 per 100 thousand; in 2017 - 6.43 per 100 thousand and in 2018 - 5.86 per 100 thousand. There were improved: the diagnostics of cerebrovascular pathology and its algorithm, modern reperfusion methods of treatment (thrombolysis, thromboextraction) were introduced into practice, outpatient observation. The equipment and trained specialists concentration on the basis of the Center allowed the creation of the Center "full cycle". Maintaining the city register of pediatric stroke made it possible to compare Russian data with those available in the literature and to establish international cooperation with the International Pediatric Stroke Organization. Conclusion. The establishment of the Center is an important example of interdisciplinary interaction in pediatrics. The City Register of Pediatric Stroke will make it possible to assess the problem of childhood stroke in Moscow. The accumulated organizational, medical and diagnostic, scientific, international and educational experience of the Center can be introduced in other regions of the Russian Federation to improve the provision of medical care to children and to solve the most important problem - preserving the health of the country's child population.

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Vlasova, A. V., T. A. Tenovskaya, L. V. Dymnova, et al. "Primary pediatric stroke center in the multidisciplinary pediatric hospital. New reality in pediatrics." City Healthcare 1, no. 1 (2020): 51–59. http://dx.doi.org/10.47619/2713-2617.zm.2020.v1i1;51-59.

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Background. The increase in the number of diagnosed strokes in children, significant distinctive features and complexity of diagnosis, treatment and prevention of cerebrovascular diseases in children compared with adults, the impossibility of direct extrapolation of therapeutic recommendations from adult practice to pediatrics required the creation of specialized primary centers of pediatric stroke in Russia. Purpose. The purpose of this article is to describe the experience of organizing a Center for the treatment of children and adolescents with cerebrovascular diseases (hereinafter referred to as the Center) on the basis of the multidisciplinary pediatric hospital of the Morozovskaya Children’s City Clinical Hospital of Moscow Healthcare Department, the introduction of modern methods of diagnosis and treatment of strokes in pediatrics, the organization of preventive measures, maintaining the city register of children’s stroke, coordinating the provision of medical care to children with cerebrovascular diseases at various levels in the city of Moscow. Materials and methods. The presented experience of organizing and operating the Center covers the period from 2014 to 2019. Researchers used descriptive, statistical, and comparative analysis to demonstrate the Center’s performance and justify proposed improvements in diagnostics, management of pediatric patients with cerebrovascular disease, and relapse prevention. Results. In the course of the organization and operation of the Center, there was assessed the frequency of children’s strokes in the city: in 2015 - 6.59 cases per 100 thousand of the child population of Moscow; in 2016 - 6.51 per 100 thousand; in 2017 - 6.43 per 100 thousand and in 2018 - 5.86 per 100 thousand. There were improved: the diagnostics of cerebrovascular pathology and its algorithm, modern reperfusion methods of treatment (thrombolysis, thromboextraction) were introduced into practice, outpatient observation. The equipment and trained specialists concentration on the basis of the Center allowed the creation of the Center «full cycle». Maintaining the city register of pediatric stroke made it possible to compare Russian data with those available in the literature and to establish international cooperation with the International Pediatric Stroke Organization. Conclusion. The establishment of the Center is an important example of interdisciplinary interaction in pediatrics. The City Register of Pediatric Stroke will make it possible to assess the problem of childhood stroke in Moscow. The accumulated organizational, medical and diagnostic, scientific, international and educational experience of the Center can be introduced in other regions of the Russian Federation to improve the provision of medical care to children and to solve the most important problem - preserving the health of the country’s child population.

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Högström, Gabriel, Anna Nordström, Marie Eriksson, and Peter Nordström. "Risk Factors Assessed in Adolescence and the Later Risk of Stroke in Men: A 33-Year Follow-Up Study." Cerebrovascular Diseases 39, no. 1 (2014): 63–71. http://dx.doi.org/10.1159/000369960.

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Background: Stroke is a common cause of death, and a leading contributor to long-term disability. The cost associated with the disease is great. Several modifiable risk factors for stroke have been found in older cohorts; however, no study to date has investigated the effects of these risk factors from late adolescence. Methods: The study cohort comprised 811,579 Swedish men (mean age, 18 years) that participated in the mandatory military conscription service in Sweden between 1969 and 1986. Some risk factors for stroke, such as body mass index, systolic and diastolic blood pressure, and cognitive function, were assessed at conscription. Aerobic fitness was also assessed at conscription, using a braked ergometer cycle test. Other risk factors for stroke, including stroke in subjects' parents, and socioeconomic factors including highest achieved level of education and annual income 15 years after conscription, were collected through national register linkage using the personal identification number. Stroke diagnosis among the study participants was tracked in the National Hospital Discharge Patient Register. Results: During a median follow-up period of 33 years 6,180 ischemic strokes and 2,104 hemorrhagic strokes were diagnosed in the cohort at a mean age of 47.9 years. Strong independent risk factors (all p <1.0 × 10−6) for ischemic stroke included low aerobic fitness (hazard ratio [HR], 0.84 per standard deviation [SD] increase), high BMI (HR, 1.15 per SD increase), diabetes (HR, 2.85), alcohol intoxication (HR, 1.93), low annual income (HR, 0.85 per SD decrease), and stroke in the mother (HR, 1.31). Similar risk factors were found for hemorrhagic stroke including low aerobic fitness (HR, 0.82 per SD increase), high BMI (HR, 1.18 per SD increase) alcohol intoxication (HR, 2.92), diabetes (HR, 2.06), and low annual income (HR, 0.75). The population attributable risks associated with all evaluated risk factors were 69% for ischemic stroke and 88% for hemorrhagic stroke (p < 0.001 for both). Conclusions: In the present study we have shown that several known risk factors for stroke are present already in late adolescence, and that they are independent of each other. The strongest risk factors were low physical fitness, high BMI, diabetes, low annual income and a maternal history of stroke. Several of the aforementioned risk factors are potentially modifiable.

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Mortensen, Janne Kaergaard, Rolf Ankerlund Blauenfeldt, Jakob Nebeling Hedegaard, et al. "Prevalence and impact of SARS-CoV-2 infection among patients with acute ischaemic stroke: a nationwide register-based cohort study in Denmark." BMJ Open 14, no. 3 (2024): e081527. http://dx.doi.org/10.1136/bmjopen-2023-081527.

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ObjectivesAn increased risk of stroke has been reported among patients with COVID-19 caused by SARS-CoV-2. We aimed to investigate the nationwide prevalence of SARS-CoV-2 among patients with acute ischaemic stroke and to study the impact on stroke severity, quality of care and mortality on an individual patient level.DesignThis was a nationwide register-based cohort study.SettingWe used data from several Danish registers which were linked at an individual patient level using the unique civil registration number assigned to all Danish citizens. Patients were identified from the Danish Stroke Registry and information on SARS-CoV-2 infection status was collected from the Danish National COVID-19 Registry. Concurrent SARS-CoV-2 infection was defined as a positive PCR test within 31 days prior to, and 1 day after, stroke admission. Information on comorbidity was collected from the Danish National Patient Registry and information on vital status was collected from the Danish Civil Registration System.ParticipantsA total of 11 502 patients admitted with acute ischaemic stroke from 10 March 2020 to 31 May 2021 were included in the study.ResultsAmong the included patients, the majority (84.6%) were tested for SARS-CoV-2, but only 68 had a positive test. These patients were more prone to have atrial fibrillation and were more often treated with reperfusion therapy. They had a significantly increased risk of severe stroke (adjusted relative risk (aRR) 1.93, 95% CI: 1.22 to 3.04) and a significantly increased 30-day mortality risk (aRR 2.29, 95% CI: 1.19 to 4.39). There was no difference in the proportion of patients fulfilling relevant performance measures on quality of care.ConclusionIn this nationwide study, only 0.6% of patients with acute ischaemic stroke were tested positive for a concurrent SARS-CoV-2 infection. The patients with SARS-CoV-2 presented with more severe strokes.

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Ebrahim, S., D. Barer, and F. Nouri. "Affective Illness After Stroke." British Journal of Psychiatry 151, no. 1 (1987): 52–56. http://dx.doi.org/10.1192/bjp.151.1.52.

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Mood assessments were made after six months of 149 survivors taken from a register of all patients admitted to hospital with acute stroke. Using a General Health Questionnaire score of 12 or more as a criterion of important affective illness, its prevalence was 23%. There was no difference in risk of affective illness between left and right hemisphere strokes. Affective illness was strongly associated with functional ability, with limb weakness and with longer hospital stay in those with good functional recovery. Only 15% of those with high scores were receiving antidepressant drugs. The general practitioner is in the best position to detect psychiatric illness in stroke survivors; the use of mood rating scales such as the GHQ, in conjunction with clinical assessment may improve detection.

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Sundelin, Heléne E. K., Anna Walås, Jonas Söderling, Peter Bang, and Jonas F. Ludvigsson. "Long-Term Mortality in Children With Ischemic Stroke: A Nationwide Register-Based Cohort Study." Stroke 53, no. 3 (2022): 837–44. http://dx.doi.org/10.1161/strokeaha.121.034797.

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Background and Purpose: Ischemic stroke is a common cause of death in adults, however, mortality after pediatric ischemic stroke is not well explored. We investigate long-term and cause-specific mortality in children with ischemic stroke and their first-degree relatives. Methods: Through nationwide Swedish registers, we identified 1606 individuals <18 years old with ischemic stroke between 1969 and 2016 and their first-degree relatives (n=5714). Each individual with ischemic stroke was compared with 10 reference individuals (controls) matched for age, sex, and county of residence. Our main analysis examined 1327 children with ischemic stroke still alive 1 week after the event. First-degree relatives to children with ischemic stroke were compared with first-degree relatives to the reference individuals. Using a Cox proportional hazard regression model, the risk of overall and cause-specific mortality was computed in individuals with pediatric ischemic stroke and their first-degree relatives. Results: The mortality rate in the first 6 months was 40.1 (95% CI, 24.7–55.6) per 1000 person-years compared with 1.1/1000 in controls (95% CI, 0.3–1.9). The overall mortality risk was hazard ratio (HR)=10.8 (95% CI, 8.1–14.3) and remained elevated beyond 20 years (HR=3.9 [95% CI, 2.1–7.1]). Children with ischemic stroke were at increased risk of death from neurological diseases (HR=29.9 [95% CI, 12.7–70.3]), cardiovascular diseases (HR=6.2 [95% CI, 1.8–22.2]), cancers (HR=6.5 [95% CI, 2.6–15.9]) and endocrine, nutritional and metabolic diseases (HR=49.2 [95% CI, 5.7–420.8]). First-degree relatives to children with ischemic stroke had an increased mortality risk (HR=1.21 [95% CI, 1.05–1.39]), with the highest risk among siblings (HR=1.52 [95% CI, 1.09–2.11]) and relatives to individuals with ischemic stroke >28 days of age (HR=1.23 [95% CI, 1.06–1.42]) compared with the relatives of the controls. Conclusions: Long-term mortality increased after pediatric ischemic stroke, even 20 years later, with neurological diseases as the most frequent cause of death.

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Alifirova, V. M., Ye V. Kabanova, O. M. Antukhova, and N. G. Brazovskaya. "Special features of care of stroke patients in a closed territorial formation on hospital period." Bulletin of Siberian Medicine 10, no. 2 (2011): 63–67. http://dx.doi.org/10.20538/1682-0363-2011-2-63-67.

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1168 cases of acute stroke were investigated with the method of Hospital Stroke Register. Computer-based tomography was performed in 93,9% cases, autopsy — in 2,4% cases. Ischemic stroke prevailed in all the age groups. Mortality rate was 25,5%, 24% stroke patients are needed in help.

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Skärlund, Mikael, Signild Åsberg, Marie Eriksson, and Erik Lundström. "Tenecteplase compared to alteplase in real-world outcome: A Swedish Stroke Register study." Upsala Journal of Medical Sciences 129 (October 9, 2024): e10459. http://dx.doi.org/10.48101/ujms.v129.10459.

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Background: Tenecteplase is increasingly used off-label as an alternative to alteplase for ischemic stroke thrombolysis. Our aim was to evaluate the safety of tenecteplase versus alteplase in comprehensive real-world data. Methods: We compared the outcomes for adult patients with acute ischemic stroke treated with alteplase or tenecteplase, registered in the Swedish Stroke Register between January 1, 2018 and December 31, 2020. The primary outcome was symptomatic intracerebral hemorrhage or death during hospital stay. Secondary outcomes were death within 90 days, modified Rankin Scale at 90 days, and mean door-to-needle time (DNT). Results: There were no significant differences in age or risk factors between 6,560 patients (45% women, mean age 74) treated with alteplase and 888 patients (43% women, mean age 74) treated with tenecteplase, although tenecteplase was more commonly used in non-university hospitals, hospitals with high use of thrombolysis, and in wake-up strokes. Tenecteplase was not non-inferior compared to alteplase in terms of symptomatic intracerebral hemorrhage or death during hospital stay (13.2% vs. 10.7%, absolute risk difference [95% confidence interval, CI] 2.5% [0.1 to 4.9%], adjusted odds ratio 1.44 [1.07–1.94]). There were no significant differences in functional outcome or death at 90 days, but tenecteplase was associated with decreased DNT (mean difference 9 min). Conclusion: Tenecteplase was not non-inferior in safety outcome, although associated with decreased DNT. As accumulating randomized controlled studies support the non-inferiority of tenecteplase regarding functional outcome, it is important to keep scrutinizing the safety outcomes.

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Obaid, Majed, Clare Flach, Iain Marshall, Charles D. A. Wolfe, and Abdel Douiri. "Long-Term Outcomes in Stroke Patients with Cognitive Impairment: A Population-Based Study." Geriatrics 5, no. 2 (2020): 32. http://dx.doi.org/10.3390/geriatrics5020032.

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This study assesses five year outcomes of patients with cognitive deficits within the first three months after stroke. Population-based data from the South London Stroke Register between 1995 and 2018 were studied. Cognitive function was assessed using the Abbreviated-Mental-Test or Mini-Mental-State-Examination. Multivariable Poisson regression models with robust standard errors were constructed, to evaluate relative risks (RRs) and associations between post-stroke deterioration in cognitive function during the first three months on dependency, mortality, depression and institutionalisation. A total of 6504 patients with first-ever strokes were registered with a mean age of 73 (SD: 13.2). During the first three months post-stoke, approximately one-third of these stroke survivors either cognitively improved (37%), deteriorated (30%) or remained unchanged (33%). Post-stroke cognitive impairment was associated with increases, in five years, of the risks of mortality, dependency, depression and being institutionalised by RRs 30% (95% confidence interval: 1.1–1.5), 90% (1.3–2.6), 60% (1.1–2.4) and 50% (1.1–2.3), respectively. Deterioration in cognitive function by 10% or more between seven days and three months was associated with an approximate two-fold increased risk in mortality, dependency, and being institutionalised after one year, compared to stable cognitive function; RRs 80% (1.1–3.0), 70% (1.2–2.4) and two-fold (1.3–3.2), respectively. Monitoring further change to maintain cognitive abilities should be a focus to improve outcomes.

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Wein, Alan J. "Impact of Urinary Incontinence After Stroke: Results From a Prospective Population-Based Stroke Register." Journal of Urology 173, no. 6 (2005): 2057. http://dx.doi.org/10.1016/s0022-5347(05)60226-1.

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Busch, M. A., C. Coshall, P. U. Heuschmann, C. McKevitt, and C. D. A. Wolfe. "Sociodemographic differences in return to work after stroke: the South London Stroke Register (SLSR)." Journal of Neurology, Neurosurgery & Psychiatry 80, no. 8 (2009): 888–93. http://dx.doi.org/10.1136/jnnp.2008.163295.

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Kolominsky-Rabas, Peter L., Max-Josef Hilz, Bernhard Neundoerfer, and Peter U. Heuschmann. "Impact of urinary incontinence after stroke: Results from a prospective population-based stroke register." Neurourology and Urodynamics 22, no. 4 (2003): 322–27. http://dx.doi.org/10.1002/nau.10114.

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Fahey, Marion, Anthony Rudd, Yannick Béjot, Charles Wolfe, and Abdel Douiri. "Development and validation of clinical prediction models for mortality, functional outcome and cognitive impairment after stroke: a study protocol." BMJ Open 7, no. 8 (2017): e014607. http://dx.doi.org/10.1136/bmjopen-2016-014607.

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IntroductionStroke is a leading cause of adult disability and death worldwide. The neurological impairments associated with stroke prevent patients from performing basic daily activities and have enormous impact on families and caregivers. Practical and accurate tools to assist in predicting outcome after stroke at patient level can provide significant aid for patient management. Furthermore, prediction models of this kind can be useful for clinical research, health economics, policymaking and clinical decision support.Methods2869 patients with first-ever stroke from South London Stroke Register (SLSR) (1995–2004) will be included in the development cohort. We will use information captured after baseline to construct multilevel models and a Cox proportional hazard model to predict cognitive impairment, functional outcome and mortality up to 5 years after stroke. Repeated random subsampling validation (Monte Carlo cross-validation) will be evaluated in model development. Data from participants recruited to the stroke register (2005–2014) will be used for temporal validation of the models. Data from participants recruited to the Dijon Stroke Register (1985–2015) will be used for external validation. Discrimination, calibration and clinical utility of the models will be presented.EthicsPatients, or for patients who cannot consent their relatives, gave written informed consent to participate in stroke-related studies within the SLSR. The SLSR design was approved by the ethics committees of Guy’s and St Thomas’ NHS Foundation Trust, Kings College Hospital, Queens Square and Westminster Hospitals (London). The Dijon Stroke Registry was approved by the Comité National des Registres and the InVS and has authorisation of the Commission Nationale de l’Informatique et des Libertés.

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Eriksson, Hanna, Karin Wirdefeldt, Signild Åsberg, and Johan Zelano. "Family history increases the risk of late seizures after stroke." Neurology 93, no. 21 (2019): e1964-e1970. http://dx.doi.org/10.1212/wnl.0000000000008522.

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ObjectiveTo assess the association between a family history of epilepsy and risk of late poststroke seizures (LPS).MethodsThis register-based cohort study was based on adult patients from the Swedish Stroke Register (Riksstroke) with stroke from 2001 to 2012 and no prior epilepsy. LPS (>7 days after stroke) and epilepsy were ascertained in cases and in their first-degree biological relatives by cross-referencing Riksstroke, the Multi-Generation Register, and the National Patient Register.ResultsOf 86,550 patients with stroke, a family history of epilepsy was detected in 7,433 (8.6%), and LPS (>7 days after stroke) occurred in 7,307 (8.4%). The survival-adjusted risk of LPS was higher in patients with compared to those without a family history of epilepsy: 6.8% (95% confidence interval [CI] 6.2%–7.4%) vs 5.9% (95% CI 5.7%–6.1%) at 2 years and 9.5% (95% CI 8.7%–10.3%) vs 8.2% (95% CI 8.0%–8.4%) at 5 years. In a Cox model adjusted for age, sex, and stroke type, the hazard ratio (HR) for LPS in patients with stroke with ≥1 relative with epilepsy was 1.18 (95% CI 1.09–1.28). The increased HR remained significant with adjustments for stroke severity and in multiple sensitivity analyses. A higher risk for patients with stroke with >1 relative with epilepsy was also seen but was not significant in all Cox models.ConclusionsAlthough stroke characteristics remain the most important risk factors for LPS, having a first-degree relative with epilepsy also increases the risk in a multivariate analysis. The findings highlight the need for family history assessment in patients with stroke and the need for future studies on genetic vulnerability and environmental factors that may aid in the identification of at-risk individuals.

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Bergh, Elin, Torunn Askim, Ole Morten Rønning, Stian Lydersen, and Bente Thommessen. "Impact of a stroke care pathway on self-perceived health 3 months after stroke." Journal of Rehabilitation Medicine 57 (February 18, 2025): jrm42443. https://doi.org/10.2340/jrm.v57.42443.

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Background: A national stroke care pathway aiming at reducing time delays in stroke care was implemented in Norway in 2018. This study aimed to investigate the impact of goal attainment in the pre- and intrahospital care pathway on self-perceived health 3 months after stroke. Methods: Data from the Norwegian Stroke Register (NSR) from 2019 were used. Patients were classified into attainment or non-attainment groups, depending on goal achievement of the SCP. Linear regression analyses were used to assess a possible association between goal attainment and self-perceived health evaluated by EQ-5D-5L and EQ-VAS at 3 months post-stroke. Results: Among 4,133 included patients, 908 (22%) were included in the attainment group. We found no effect of goal attainment upon mean EQ-5D-5L. However, when adjusting for stroke severity, attaining the SCP was significantly associated with self-perceived health. Conclusion: In this study, with a cohort of patients with mild to moderate strokes, we found no association between attaining goals of the stroke care pathway and self-perceived health. However, stroke severity might have acted as a suppressor variable underscoring the importance of stroke severity for self-perceived health.

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Appelros, Peter, Fredrik Jonsson, Signild Åsberg, et al. "Trends in Stroke Treatment and Outcome between 1995 and 2010: Observations from Riks-Stroke, the Swedish Stroke Register." Cerebrovascular Diseases 37, no. 1 (2014): 22–29. http://dx.doi.org/10.1159/000356346.

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Sennfält, Stefan, Jesper Petersson, Teresa Ullberg, and Bo Norrving. "Patterns in hospital readmissions after ischaemic stroke – An observational study from the Swedish stroke register (Riksstroke)." European Stroke Journal 5, no. 3 (2020): 286–96. http://dx.doi.org/10.1177/2396987320925205.

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Introduction While acute treatment and secondary prevention in stroke have undergone major improvements, hospital readmission after index stroke remains high. However, there are few reports on long-term readmission patterns. Patients and methods For this prospective observational study, data on demographics, functional status and living conditions were obtained from the Swedish Stroke Register (Riksstroke). Data on comorbidity and hospital readmissions up to five years post-index stroke were obtained from the Swedish National Patient Register. Patients were grouped based on number of readmissions: low (0–1) intermediate (2–4), high (5–9) or very high (≥10). Results Of the 10,092 patients included, 43.7% had been readmitted within 12 months and 74.0% within 5 years. There was an average of three readmissions per individual during the five-year interval. A small group of patients with a high-comorbidity burden accounted for the majority of readmissions: approximately 20% of patients accounted for 60% of readmissions, and 5% of patients accounted for 25%. Circulatory conditions were the most common cause followed by infectious disease, stroke, trauma and diseases of the nervous system other than stroke. The proportion of readmissions due to stroke decreased sharply in the first six months. Conclusion A small number of patients with a high degree of comorbidity accounted for the majority of hospital readmissions after index stroke. Our results highlight the need for further development of strategies to support high-risk comorbid stroke patients in the community setting. Further research describing characteristics and healthcare utilisation patterns in this group is warranted.

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Shaked, S., and J. Naveh. "Three Aramaic seals of the Achaemenid period." Journal of the Royal Asiatic Society of Great Britain & Ireland 118, no. 1 (1986): 21–29. http://dx.doi.org/10.1017/s0035869x00139073.

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This seal, of unknown provenance, has an Aramaic inscription which is engraved on a scaraboid hematite pierced lengthwise. It measures 17×13 mm, with 9 mm of thickness. The oval surface, which is slightly damaged at one point, is divided by a double line into two registers. Six letters are engraved in the upper, and five in the lower register, giving the following reading:The letters are fairly large and fill the whole space. All the letters in the upper register stand at the same height on the double line. Normally, however, lamed is higher than the ceiling line of the other letters, while nun and taw are usually drawn with a stroke which goes below the bottom line formed by the other letters. In the lower register the taw and the two nuns seem to go farther down than the alef and the dalet.

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Rücker, Viktoria, Peter U. Heuschmann, Martin O’Flaherty, et al. "Twenty-Year Time Trends in Long-Term Case-Fatality and Recurrence Rates After Ischemic Stroke Stratified by Etiology." Stroke 51, no. 9 (2020): 2778–85. http://dx.doi.org/10.1161/strokeaha.120.029972.

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Background and Purpose: Data on long-term survival and recurrence after stroke are lacking. We investigated time trends in ischemic stroke case-fatality and recurrence rates over 20-years stratified by etiological subtype according to the Trial of ORG 10172 in Acute Stroke Treatment classification within a population-based stroke register in Germany. Methods: Data was collected within the Erlangen Stroke Project, a prospective, population-based stroke register covering a source population of 105 164 inhabitants (2010). Case fatality and recurrence rates for 3 months, 1 year, and 5 years were estimated with Kaplan-Meier estimates. Sex-specific time trends for case-fatality and recurrence rates were estimated with Cox regression. We adjusted for age, sex, and year of event and stratified for etiological subtypes. A sensitivity analysis with competing risk analysis for time trends in recurrence were performed. Results: Between 1996 and 2015, 3346 patients with first ischemic stroke were included; age-standardized incidence per 100 000 was 75.8 in women and 131.6 in men (2015). Overall, 5-year survival probabilities were 50.4% (95% CI, 47.9–53.1) in women and 59.2% (95% CI, 56.4–62.0) in men; 5-year survival was highest in patients with first stroke due to small-artery occlusion (women, 71.8% [95% CI, 67.1–76.9]; men, 75.9% [95% CI, 71.3–80.9]) and lowest in cardioembolic stroke (women, 35.7% [95% CI, 31.0–41.1]; men, 47.8% [95% CI, 42.2–54.3]). Five-year recurrence rates were 20.1% (95% CI, 17.5–22.6) in women and 20.1% (95% CI, 17.5–22.7) in men; 5-year recurrence rate was lowest in women in stroke due to small artery occlusion 16.0% (95% CI, 11.7–20.1) and in men in large-artery atherosclerosis 16.6% (95% CI, 8.7–23.9); highest risk of recurrence was observed in undefined strokes (women, 22.3% [95% CI, 17.8–26.6]; men, 21.4% [95% CI, 16.7–25.9]). Cox regression revealed improvements in case-fatality rates over time with differences in stroke causes. No time trends in recurrence rates were observed. Conclusions: Long-term survival and recurrence varied substantially by first stroke cause. Survival probabilities improved over the past 2 decades; no major trends in stroke recurrence rates were observed.

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