2011, Number 5
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Rev Mex Neuroci 2011; 12 (5)
Risk factors, causes, and outcome in stroke types in Mexico. The RENAMEVASC Study
Cantú-Brito C, Ruiz-Sandoval JL, Chiquete E, Arauz A, León-Jiménez C, Murillo-Bonilla LM, Villarreal-Careaga J, Barinagarrementería F, Fernández JA, Torres B, Rodríguez-Leyva I, Rangel-Guerra R
Language: Spanish
References: 24
Page: 224-234
PDF size: 266.16 Kb.
ABSTRACT
Background and objectives: In spite that stroke has become a public health problem in Mexico, there are few information regarding several issues on strtoke epidemiology. The main objectives of the present study were to determine, by means of a multicentric stroke registry, the prevalence of the stroke types, their vascular risk factors and the short-term outcome.
Patients and methods: Prospective observational study of consecutive cases of stroke recruited in 25 hospitals (in 14 states of Mexico). The following information was obtained: demographic data, vascular risk factors, mechanisms and causes of stroke types, and clinical outcome. Descriptive statistical analysis (frequencies and medians) using χ
2 y Kruskal-Wallis for contrasting differences among stroke types.
Resulted: We studied 2000 patients: women 55%, men 45% (p ‹ 0.001) with median age of 64 years (IQR 49-75). Stroke types: tranient ischemic attack 5%, cerebral infarction 52%, intracerebral hemorrhage (ICH) 28%, subarachnoid hemorrhage (SAH) 12.0%, and cerebral venous thrombosis (CVT) 3.0%. Causes of cerebral infarct: atherosclerosis 14.7%, cardioembolism 24.7%, small vessel disease 19.4%, other 4.6%, undetermined 36.6%. Causes of ICH: hypertensive 67%, vascular malformations 7.8%, amiloid angiopaty 4%, hematologic disorders 4%, other 8%, undetermined 10%. Causes of SAH: aneurysm 86%, perimesencephalic 6%, other 2%, undetermined 6%. Causes CVT: puerperium/pregnancy 47%, contraceptives agents 13%, other 17%, undetermined 23%. Short-term clinical outcome (30 days): Excellent recovery (Rankin 0/1) 41%; mild and moderate disability (R 2/3) 18%; severe disability (R 4/5) 20% and death 21%.
Conclusions: Main mechanisms and causes of stroke in Mexico are described, revealing a higher frequency of ICH and CVT in Mexico than occidental countries. More than half of patients had poor outcome because they died or had some grade of disability.
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