Rural-Urban Differences in Stroke Types, Risk Factors, Severity and Prognosis in Babol, Northern Iran

Saadat, Payam; Ahmadi Ahangar, Alijan; Khafri, Soraya; Kalantar, Mandana; Dariaie, Azin; Alijanpour, Shayan; Mortazavinejhad, Roghayyeh; Faraji, Sekineh; Frajzadeh , Fatemeh

doi:10.18502/ehj.v4i2.258

Volume 4, Issue 2 (December 2018) Elderly Health Journal 2018, 4(2): 68-74 | Back to browse issues page

‎ 10.18502/ehj.v4i2.258

‎ 20.1001.1.24236179.2018.4.2.3.9

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Saadat P, Ahmadi Ahangar A, Khafri S, Kalantar M, Dariaie A, Alijanpour S, et al . Rural-Urban Differences in Stroke Types, Risk Factors, Severity and Prognosis in Babol, Northern Iran. Elderly Health Journal 2018; 4 (2) :68-74
URL: http://ehj.ssu.ac.ir/article-1-122-en.html

Rural-Urban Differences in Stroke Types, Risk Factors, Severity and Prognosis in Babol, Northern Iran

Payam Saadat

, Alijan Ahmadi Ahangar ^*

, Roghayyeh Mortazavinejhad

, Sekineh Faraji

, Fatemeh Frajzadeh

Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran , ahmadiahangaralijan@yahoo.com

Abstract: (3623 Views)

Introduction: Stroke recognized as the third most common cause of death. Stroke survivors often suffer a large amount of physical and mental disability. Due to assess difference between stroke types, progression and distribution of risk factors according residential status, to get correct information for prevention planning and management, this study was conducted.

Methods: This descriptive cross-sectional study on stroke patient from 2016 to 2017 that admitted to Ayatollah Rohani Hospital of Babol was conducted. Type of stroke, their severity, risk factors, and urban or rural area of residence of patients were recorded in the checklist. The chi-square test was used to compare frequencies of gender, and stroke risk assessment between the urban and rural residents. Binary logistic regression modeling was used to estimate the association of risk factors with living in urban and rural areas. The results were expressed as multivariable-adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs). A two-sided p < 0.05 was considered statistically significant. All data analyses were performed, using SPSS statistical analysis software.

Results: Of 241 stroke patients, 133 patients (55 %) were female and 213 patients (88.4 %) were ischemic. Also, 140 cases were (58 %) rural. Embolic strokes more in urban population and thrombotic strokes were more in rural populations. Hyperlipidemia was more in urban than rural p = 0.01. Severity of stroke in admission time (p = 0.03) and at discharge (p = 0.005) was more in rural than urban. The mortality was higher in rural 12 (8.6) vs. 2 (2) urban resident,( p = 0.03).

Conclusion: Rural patients had more severity, thrombotic type and mortality than urban. Suitable policy regard to residential parameter is suggested.

Keywords: Stroke, Risk Factors, Rural, Urban

Full-Text [PDF 683 kb] (953 Downloads) | | Full-Text (HTML) (1104 Views)

Type of Study: Research | Subject: General
Received: 2018/07/14 | Accepted: 2018/12/16 | Published: 2018/12/29

References

1. Esenwa C, Gutierrez J. Secondary stroke prevention: challenges and solutions. Vascular Health and Risk Management. 2015; 11: 437-50.

2. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P. Risk factors for ischemic and intracerebral hemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010; 376(9735): 112-23.

3. Reeves MJ, Bushnell CD, Howard G, Gargano JW, Duncan PW, Lynch G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. The Lancet Neurology. 2008; 7(10): 915-26.

4. Daneshfard B, Izadi S, Shariat A, Toudaji MA, Beyzavi Z, Niknam L. Epidemiology of stroke in Shiraz, Iran. Iranian Journal of Neurology. 2015; 14(3): 158-63.

5. Ahangar AA, Ashraf Vaghefi SB, Ramaezani M. Epidemiological evaluation of stroke in Babol, northern Iran (2001–2003). European Neurology. 2005; 54(2): 93-7.

6. Romero JR, Morris J, Pikula A. Stroke prevention: modifying risk factors. Therapeutic Advances in Cardiovascular Disease. 2008; 2(4): 287-303.

7. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurology. 2009; 8(4): 355-69.

8. Yew KS, Cheng EM. Diagnosis of acute stroke. American Family Physician. 2015; 91(8): 528-536.

9. Muchada M, Rubiera M, Rodriguez-Luna D, Pagola J, Flores A, Kallas J, et al. Baseline national institutes of health stroke scale–adjusted time window for intravenous tissue- type plasminogen activator in acute ischemic stroke. Stroke. 2014; 45(4): 1059-63.

10. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine. 18th. New York: Mc Grow-Hill. 2012.

11. Dadjou Y, Kermani-Alghoraishi MK, Sadeghi M, Talaei M, Yousefy A, Oveisgharan S, et al. The impact of health-related quality of life on the incidence of ischaemic heart disease and stroke; a cohort study in an Iranian population. Acta Cardiologica. 2016; 71(2): 221-6.

12. Hashemi-Fard A, Saffari SH, Adnan R. Analysis of hospitalization length for cerebrovascular accident patients in Sabzevar Vaseyee hospital using count regression models. Daneshvar Medicine. 2014; 21(109): 17-24. [Persian]

13. Lashkaripour K, Moghtaderi A, Sajadi SAR, Faghihinia M. Prevalence of post stroke depression and its relationship with disability and lesion location. Journal of Fundamentals of Mental Health. 2008; 10(3): 191-7.

14. Mazaheri SH, Beheshti F, Hosseinzadeh A, Mazdeh M, Ghiasian M. Epidemiologic study of cardinal risk factors of stroke in patients who referred to Farshchian hospital of Hamadan during 2014-2015. Scientific Journal of Hamadan University of Medical Sciences. 2016; 22(4): 331-7. [Persian]

15. Farghaly WM, El-Tallawy HN, Shehata GA, Rageh TA, Abdel-Hakeem NM, Elhamed MA, et al. Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga district, new valley, Egypt. Neuropsychiatric Disease and Treatment. 2013; 9: 1785.

16. Kaur P, Verma SJ, Singh G, Bansal R, Paul SP, Singla M, et al. Stroke profile and outcome between urban and rural regions of Northwest India: Data from Ludhiana population-based stroke registry European Stroke Journal. 2017; 2(4): 377–384.

17. Harwell TS, Blades LL, Oser CS, Fogle CC, Helgerson SD, Gohdes D, et al. Rural community knowledge of stroke warning signs and risk factors. Preventing Chronic Disease. 2005; 2(2).

18. Young J, Forster A. Review of stroke rehabilitation. British Medical Journal. 2007; 334(7584): 86-90.

19. Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, et al. Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum stroke registry. Stroke.2009; 40(4): 1212–8.

20. Mi T, Sun S, Du Y, Guo S, Cong L, Cao M, et al. Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China. Brain and Behavior. 2016; 6(5).

21. Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. The Journal of the American Medical Association. 2013; 310(9): 959–68.

22. Nakibuuka J, Sajatovic M, Nankabirwa J, Furlan AJ, Kayima J, Ddumba E, et al. Stroke-risk factors differ between rural and urban communities: population survey in Central Uganda. Neuroepidemiology. 2015; 44(3): 156-65.

23. Correia M, Silva MR, Matos I, Magalhães R, Lopes JC, Ferro JM, et al. Prospective community-based study of stroke in Northern Portugal: incidence and case fatality in rural and urban populations. Stroke. 2004; 35(9):2048-53.

24. Xu F, Ah Tse LA, Yin X, Yu IT, Griffiths S. Impact of socio-economic factors on stroke prevalence among urban and rural residents in Mainland China. BioMed Centeral Public Health. 2008; 8(170).

25. Kaup AO, Dos Santos BF, Victor ES, Cypriano AS, Lottenberg CL, Cendoroglo Neto M, et al. Georeferencing deaths from stroke in São Paulo: an intra-city stroke belt?. International Journal of Stroke. 2015; 10(100): 69-74.

26. Howard G, Kleindorfer DO, Cushman M, Long DL, Jasne A, Judd SE, et al. Contributors to the excess stroke mortality in rural areas in the United States. Stroke. 2017; 48(7): 1773-8.

27. Nishi N, Sugiyama H, Kasagi F, Kodama K, Hayakawa T, Ueda K, et al. Urban–rural difference in stroke mortality from a 19-year cohort study of the Japanese general population: NIPPON DATA80. Social Science & Medicine. 2007; 65(4): 822-32.

28. Patra J, Taylor B, Irving H, Roerecke M, Baliunas D, Mohapatra S, et al. Alcohol consumption and the risk of morbidity and mortality for different stroke types-a systematic review and meta-analysis. BioMed Central Public Health. 2010; 10(258).

29. Baalwa J, Byarugaba BB, Kabagambe E, Otim A. Prevalence of overweight and obesity in young adults in Uganda. African Health Sciences. 2010; 10(4): 367-73. Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A, et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban south India—the Chennai urban rural epidemiology study (CURES-17). Diabetologia. 2006; 49(6): 1175-8.