Stroke in Birjand, Iran: A Hospital-Based Study of Acute Stroke

BACKGROUND: Stroke, or cerebrovascular accident (CVA), is the second leading cause of death in the world and based on the World Health Organization (WHO) report in 2006, it is responsible for 9.9% of all deaths in the world which over 85% of these deaths occurred in developing countries. OBJECTIVES: The aim of this study was to investigate the data related to the frequency, risk factors, types and mortality of stroke in Birjand city. PATIENTS AND METHODS: A retrospective cohort of consecutive patients with diagnosed stroke who were admitted to hospital (the only neurological center of Birjand) between 2002 and 2008 was designed. A stroke was defined according to clinical features and CT-scan which was confirmed by agreement of a staff neurologist. Collected data included date of admission, age, sex, and hospital outcome as well as related risk factors. RESULTS: Totally, 1219 stroke (85.4% ischemic type) with the mean age of 69.6 ± 12.9 years and female: male ratio of 1.09 was included in over 6 years. The stroke hospital admission rates were 48.6 and 103.4 /100,000 population /year in the first and the last year of the study, respectively. There was an increasing trend in stroke incidence rate during the study (P < 0.01). The most common epidemiological risk factors for stroke in our region were hypertension, cardiac diseases, a history of stroke, diabetes mellitus, dyslipidemia, and smoking (54.7, 24.4, 20.1, 14.9, 12.2, and 9%, respectively). Overall in-hospital mortality rate was 17.1%. CONCLUSIONS: The stroke hospital admission rate might be increasing in Birjand. Therefore, health care administrators and public health authorities must work harder to promote the knowledge and practice of society about the stroke related risk factors and prevention methods.