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Ischemic stroke in Morocco: a systematic review

BACKGROUND: The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco. METHODS: The present work...

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Autores principales: Kharbach, Ahmed, Obtel, Majdouline, Lahlou, Laila, Aasfara, Jehanne, Mekaoui, Nour, Razine, Rachid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936047/
https://www.ncbi.nlm.nih.gov/pubmed/31888526
http://dx.doi.org/10.1186/s12883-019-1558-1
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author Kharbach, Ahmed
Obtel, Majdouline
Lahlou, Laila
Aasfara, Jehanne
Mekaoui, Nour
Razine, Rachid
author_facet Kharbach, Ahmed
Obtel, Majdouline
Lahlou, Laila
Aasfara, Jehanne
Mekaoui, Nour
Razine, Rachid
author_sort Kharbach, Ahmed
collection PubMed
description BACKGROUND: The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco. METHODS: The present work is a systematic review that was conducted according to the recommendations of the “Preferred reporting items for systematic reviews and meta-analysis”. We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients’ proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco. RESULTS: Twenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval. CONCLUSIONS: Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco.
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spelling pubmed-69360472019-12-31 Ischemic stroke in Morocco: a systematic review Kharbach, Ahmed Obtel, Majdouline Lahlou, Laila Aasfara, Jehanne Mekaoui, Nour Razine, Rachid BMC Neurol Review BACKGROUND: The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco. METHODS: The present work is a systematic review that was conducted according to the recommendations of the “Preferred reporting items for systematic reviews and meta-analysis”. We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients’ proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco. RESULTS: Twenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval. CONCLUSIONS: Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco. BioMed Central 2019-12-30 /pmc/articles/PMC6936047/ /pubmed/31888526 http://dx.doi.org/10.1186/s12883-019-1558-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Kharbach, Ahmed
Obtel, Majdouline
Lahlou, Laila
Aasfara, Jehanne
Mekaoui, Nour
Razine, Rachid
Ischemic stroke in Morocco: a systematic review
title Ischemic stroke in Morocco: a systematic review
title_full Ischemic stroke in Morocco: a systematic review
title_fullStr Ischemic stroke in Morocco: a systematic review
title_full_unstemmed Ischemic stroke in Morocco: a systematic review
title_short Ischemic stroke in Morocco: a systematic review
title_sort ischemic stroke in morocco: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936047/
https://www.ncbi.nlm.nih.gov/pubmed/31888526
http://dx.doi.org/10.1186/s12883-019-1558-1
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