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Stroke survival, recurrence and mortality in Tbilisi, Georgia: a population-based follow-up study

English title Stroke survival, recurrence and mortality in Tbilisi, Georgia: a population-based follow-up study
Applicant Michel Patrik
Number 110939
Funding scheme SCOPES
Research institution Service de Neurologie Département des Neurosciences Cliniques CHUV
Institution of higher education University of Lausanne - LA
Main discipline Neurology, Psychiatry
Start/End 01.09.2005 - 31.10.2009
Approved amount 72'000.00
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Keywords (5)

stroke; epidemiology; survival; recurrence; mortality

Lay Summary (English)

Lead
Lay summary
Background and Purpose: Stroke is a well-established major cause of death and disability in developed countries. However population-based studies assessing stroke incidence, case-fatality, risk factors, clinical patterns, survival and mortality in developing countries are still lacking. In the framework of the Joint Research Project (JRP) of the previous SCOPES call (2000-2003), the incidence, case-fatality, clinical patterns and risk factors of stroke in a defined population of Sanzona district (approx. 50 000 inhabitants) of Tbilisi, Capital of Georgia were estimated. The results of the study were published recently (Stroke. 2004;35: 2523-2528). The present study aims to follow-up the major epidemiological patterns of stroke in the same population of Tbilisi with emphasis on survival, recurrence, case-specific mortality and predictors of mortality of the first-ever stroke cohort identified during previous JRP.
Methods: A cohort of 233 first-ever stroke patients were identified from 2000 to 2003 in Sanzona suburb of Tbilisi. This cohort is followed-up prospectively. All cases of recurrent stroke and stroke mortality are registered by means of immediate notification /referral system, and analyzed. For patients with ischemic stroke possible etiologies are defined using the TOAST criteria, and infarct subtypes using Oxfordshire Community Stroke Project classification. Hemorrhagic strokes are classified as (a) supratentorial: putaminal/thalamic, lobar; (b)infratentorial: pontic, cerebellar; (c) subarachnoid hemorrhage. The project is carried out by the same teams as in the previous JRP (2 Georgian teams of neurologists and public health specialists with close coordination with Swiss partners from the Neurology Service of the Lausanne University Hospital).
Preliminary results: Since November 2000 up to date (8/2006), 151 (65%) patients of the original cohort of 233 patients with strokes have died.Among those who died, 73 were patients with ischemic stroke, 46 - patients with intracerebral hemorrhage, 14 - patients with subarachnoid hemorrhage and 18 - patients with unspecified stroke. Stroke recurrence rate was 53% during the observation period. The most frequent causes of death were cardiac disease (myocardial infarction, congestive heart disease orarrhythmias) (32% of cases), followed by respiratory tract disease(pneumonia) in 25% of cases.
Expected impact of the project: Expected results of the JRP will increase the knowledge on stroke survival, recurrence, mortality and important causes of death for a defined population of a country in transition, and prepare a ground for changes in the focus of poststroke rehabilitation and medical care including secondary prevention with further goal to reduce the burden of stroke on individuals and on the society throughout Georgia.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

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