Highlights
- •We present long term clinical profile changes of Polish first-ever stroke patients.
- •The profile of urban Polish stroke patients has changed significantly.
- •Diagnosis and treatment of vascular risk factors has improved.
- •However, still some issues are to be improved.
Abstract
Background
Despite estimates about general trends in stroke epidemiology worldwide, there are
only a few reports of detailed longitudinal data and none of them reflects the economic
transition that occurred in Central and Eastern Europe over the last two decades.
The aim of this study was to investigate long term trends in risk factors and their
pre-stroke control as well as acute stroke clinical presentation and etiology in Polish
urban setting.
Methods
This is a retrospective registry-based analysis of consecutive acute stroke patients
from a highly urbanized area (Warsaw, Poland) admitted to a single stroke center between
1995 and 2013. Patients were divided into four time periods: 1995–1999 (n = 529), 2000–2004 (n = 1253), 2005–2009 (n = 1320) and 2010–2013 (n = 871).
Results
During the study period 3973 first-ever stroke patients were admitted. The proportion
of ischaemic strokes (88.2% to 90.9%) and male patients (45.2% to 46.2%) remained
stable throughout the whole study period. Admitted patients became older (72, 73,
74 and 76 years, consecutive time periods), were more likely to be diagnosed with hypertension
(from 61.1% to 72.8%) and disable (84.3% to 67.4%) prior to stroke. There was an increase
in pre-stroke use of antihypertensives in patients with hypertension (from 77.8% to
90.5%), antiplatelets in patients with coronary artery disease (from 33.9% to 56.5%),
vitamin K antagonists in patients with atrial fibrillation (from 6.3% to 39.8%) and
statins (from 7.6% to 26.3%). There was a decrease in mean stroke severity (9, 11,
8 and 6 points on the National Institutes of Stroke Scale) on admission and the proportion
of strokes attributed to small-vessel disease (22.0%, 20.0%, 10.6% and 8.3%).
Conclusions
Over the last two decades the profile of urban Polish stroke patients has changed
significantly and it can be attributed to marked economic improvement in Poland since
1990s. Increasing age and better management of pre-existing vascular risk factors
were accompanied by decreasing stroke severity and lower proportion of strokes attributed
to small-vessel disease.
Keywords
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Article info
Publication history
Published online: July 09, 2015
Accepted:
July 8,
2015
Received in revised form:
July 6,
2015
Received:
March 6,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
