Neuroepidemiology
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Black-white disparities in stroke mortality are well documented, but few recent studies have examined racial/ethnic disparities in stroke hospitalizations among young adults. We analyzed recent (2001-2006) trends in stroke hospitalizations and hospital case-fatality for black, Hispanic, and white adults aged 25-49 years in Florida. ⋯ Our study found a strong and persistent black-white disparity in stroke hospitalization rates for young adults. In contrast, rates were similar for Hispanics and whites. Multivariate adjustment explained the 15% excess case-fatality for blacks; the short-term mortality advantage among Hispanics was strengthened after adjustment.
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Multicenter Study Comparative Study
The time interval window between stroke onset and hospitalization and its related factors.
Successful acute stroke intervention depends on early hospitalization. The time interval between stroke onset to hospitalization was examined to identify the factors influencing the interval and also to determine whether treatment time window expansion will translate into more treatment. ⋯ Clinically more severe stroke patients were hospitalized earlier and nocturnal strokes had delayed admission. Even expanding the therapeutic time window from
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Comparative Study
Clinicoepidemiological profiles and outcomes during first hospital admission of head injury patients in Ikeja, Nigeria. A prospective cohort study.
Although head injury (HI) is a major public health problem in Nigeria and other low and middle income countries of the world, there is a paucity of data from these societies. This is largely due to under-reporting. We carried out a prospective study of the clinicoepidemiological profiles and outcomes following the first hospitalization of a cohort of head-injured patients in Ikeja, Nigeria, a metropolitan African city. ⋯ HI is a major public health problem in Nigeria, taking up at least one fifth of the neurosurgical workload. The prehospital emergency medical service is poorly organized. Determinants of a poor outcome of HI are highly prevalent, including poor accessibility to cranial CT scanning, absence or inadequacy of logistics for neurocritical care and an inadequate number of neurosurgeons.
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Comparative Study
Neurological emergencies in India--lessons learnt and strategies to improve outcomes.
Neurological emergencies account for between 2.6 and 14% of medical emergencies, a number that can be salvaged, if addressed in time. This study aimed to answer the questions of demand, type and outcome of neurological emergencies by conducting a retrospective analysis of neurological emergencies serviced by 108, the first professional emergency service in India. ⋯ Emergency medical systems should implement a prehospital stroke protocol including the use of vital sign monitoring, point-of-care clinical diagnostics and advance forewarning systems. Geriatric clinics attending to the elderly age group, especially located in rural areas, with better identification of stroke and coma as medical emergencies, either through neuroimaging or clinical diagnostic facilities, will definitely improve outcomes. As seizures form a large chunk of neurological emergencies, genetic testing and counseling to detect hereditary causes could identify and keep most victims on regulated treatment in order to reduce adverse outcomes.