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4. A scoping review of stroke registers in Sub-Saharan Africa.

Author

Youkee, Daniel, Baldeh, Mamadu, Rudd, Anthony, Soley-Bori, Marina, Wolfe, Charles DA, Deen, Gibrilla F, and Marshall, Iain J

Subjects
STROKE, GLASGOW Coma Scale, QUALITY-adjusted life years, SUMMIT meetings, BARTHEL Index
Abstract

Background: Stroke registers are recommended as a key priority by the Lancet Neurology World Stroke Organization Commission for Stroke, 2023, and the African Stroke Leaders' Summit, 2022. Aims: This scoping review aims to map where stroke registers have been implemented in Sub-Saharan Africa (SSA). The article then compares and critiques the methods and definitions used and summarizes key results from the registers. The scoping review searched EMBASE, MEDLINE, and CABI Global Health databases and included all studies with a prospective longitudinal design in SSA, where adult acute stroke was the primary condition studied. Articles were screened against inclusion and exclusion criteria independently by two authors. Summary: We identified 42 unique stroke registers from 48 individual studies. The registers were located in 19 countries, with 19 from East Africa, 15 West Africa, 6 Central Africa, and 2 from Southern Africa. Cumulatively, the registers recruited 12,345 participants with stroke, the median number of participants was 183 (interquartile range (IQR): 121–312), and the range was 50–1018. Only one study was a population-based register, and 41 were hospital-based registers. Of the hospital-based registers, 29 were single site, 10 were conducted at two sites, and 2 at three sites. Twenty-three (54.7%) of the registers were located in the capital city of their respective country, and only one of the hospital-based registers was in a self-described rural area. Length of recruitment ranged from 4 months to 6 years; the median length of recruitment was 12 months. Methodology and definitions were heterogenous between the registers. Only seven (19.4%) registers referenced the WHO STEPwise approach to implementing stroke registers. Twenty-seven (64.3%) registers used the WHO definition of stroke. The mean neuroimaging rate was 84%, and ranged from 0% to 100%. Stroke severity was measured using the National Institute of Health Stroke Scale (NIHSS) in 22 (52.4%) registers, four registers used the Glasgow Coma Scale (GCS), two registers used the miniNIHSS, one used the Scandinavian Stroke Scale, one modified Rankin Scale (mRS), and 11 registers did not report a stroke severity measure. Seventeen (40.5%) registers used the mRS to measure function, six registers used Barthel Index alone, and three registers used both mRS and Barthel Index. Only two registers included a quality-of-life measure, the EQ-5D. Eight registers included a quality-of-care measure, and 26 (61.9%) registers recorded socioeconomic status or a socioeconomic status proxy, most frequently educational attainment. Conclusions: This scoping review found high heterogeneity of methods and definitions used by stroke registers, with low uptake of the WHO stepwise method of stroke surveillance. A drive to standardize methodology would improve the comparability of stroke data in SSA. The shared use of educational attainment by registers in our review may enable future meta-analyses of inequities in stroke in SSA. Incorporating health-related quality-of-life measures, such as EQ-5D, into stroke registers should be encouraged, bringing a patient perspective, and allow the estimation of quality-adjusted life years lost to stroke. Agreement on a standardized register methodology or further promotion and uptake of the WHO stepwise method is essential to produce comparable data to improve stroke prevention and care. [ABSTRACT FROM AUTHOR]

Published
2025
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5. Multi‐phenotype analyses of hemostatic traits with cardiovascular events reveal novel genetic associations

Author

Temprano‐Sagrera, Gerard, Sitlani, Colleen M., Bone, William P., Martin‐Bornez, Miguel, Voight, Benjamin F., Morrison, Alanna C., Damrauer, Scott M., de Vries, Paul S., Smith, Nicholas L., Sabater‐Lleal, Maria, Dehghan, Abbas, Heath, Adam S, Morrison, Alanna C, Reiner, Alex P, Johnson, Andrew, Richmond, Anne, Peters, Annette, van Hylckama Vlieg, Astrid, McKnight, Barbara, Psaty, Bruce M, Hayward, Caroline, Ward‐Caviness, Cavin, O’Donnell, Christopher, Chasman, Daniel, Strachan, David P, Tregouet, David A, Mook‐Kanamori, Dennis, Gill, Dipender, Thibord, Florian, Asselbergs, Folkert W, Leebeek, Frank W.G., Rosendaal, Frits R, Davies, Gail, Homuth, Georg, Temprano, Gerard, Campbell, Harry, Taylor, Herman A, Bressler, Jan, Huffman, Jennifer E, Rotter, Jerome I, Yao, Jie, Wilson, James F, Bis, Joshua C, Hahn, Julie M, Desch, Karl C, Wiggins, Kerri L, Raffield, Laura M, Bielak, Lawrence F, Yanek, Lisa R, Kleber, Marcus E, Mueller, Martina, Kavousi, Maryam, Mangino, Massimo, Liu, Melissa, Brown, Michael R, Conomos, Matthew P, Jhun, Min‐A, Chen, Ming‐Huei, de Maat, Moniek P.M., Pankratz, Nathan, Smith, Nicholas L, Peyser, Patricia A, Elliot, Paul, de Vries, Paul S, Wei, Peng, Wild, Philipp S, Morange, Pierre E, van der Harst, Pim, Yang, Qiong, Le, Ngoc‐Quynh, Marioni, Riccardo, Li, Ruifang, Damrauer, Scott M, Cox, Simon R, Trompet, Stella, Felix, Stephan B, Völker, Uwe, Tang, Weihong, Koenig, Wolfgang, Jukema, J. Wouter, Guo, Xiuqing, Lindstrom, Sara, Wang, Lu, Smith, Erin N, Gordon, William, de Andrade, Mariza, Brody, Jennifer A, Pattee, Jack W, Haessler, Jeffrey, Brumpton, Ben M, Chasman, Daniel I, Suchon, Pierre, Turman, Constance, Germain, Marine, MacDonald, James, Braekkan, Sigrid K, Armasu, Sebastian M, Jackson, Rabecca D, Nielsen, Jonas B, Giulianini, Franco, Puurunen, Marja K, Ibrahim, Manal, Heckbert, Susan R, Bammler, Theo K, Frazer, Kelly A, McCauley, Bryan M, Taylor, Kent, Pankow, James S, Reiner, Alexander P, Gabrielsen, Maiken E, Deleuze, Jean‐François, O’Donnell, Chris J, Kim, Jihye, Kraft, Peter, Hansen, John‐Bjarne, Heit, John A, Kooperberg, Charles, Hveem, Kristian, Ridker, Paul M, Morange, Pierre‐Emmanuel, Johnson, Andrew D, Kabrhel, Christopher, Trégouët, David‐Alexandre, Malik, Rainer, Chauhan, Ganesh, Traylor, Matthew, Sargurupremraj, Muralidharan, Okada, Yukinori, Mishra, Aniket, Rutten‐Jacobs, Loes, Giese, Anne‐Katrin, van der Laan, Sander W, Gretarsdottir, Solveig, Anderson, Christopher D, Chong, Michael, Adams, Hieab HH, Ago, Tetsuro, Almgren, Peter, Amouyel, Philippe, Ay, Hakan, Bartz, Traci M, Benavente, Oscar R, Bevan, Steve, Boncoraglio, Giorgio B, Brown, Robert D, Butterworth, Adam S, Carrera, Caty, Carty, Cara L, Chen, Wei‐Min, Cole, John W, Correa, Adolfo, Cotlarciuc, Ioana, Cruchaga, Carlos, Danesh, John, de Bakker, Paul IW, DeStefano, Anita L, den Hoed, Marcel, Duan, Qing, Engelter, Stefan T, Falcone, Guido J, Gottesman, Rebecca F, Grewal, Raji P, Gudnason, Vilmundur, Gustafsson, Stefan, Harris, Tamara B, Hassan, Ahamad, Havulinna, Aki S, Holliday, Elizabeth G, Howard, George, Hsu, Fang‐Chi, Hyacinth, Hyacinth I, Arfan Ikram, M, Ingelsson, Erik, Irvin, Marguerite R, Jian, Xueqiu, Jiménez‐Conde, Jordi, Johnson, Julie A, Jukema, J Wouter, Kanai, Masahiro, Keene, Keith L, Kissela, Brett M, Kleindorfer, Dawn O, Kubo, Michiaki, Lange, Leslie A, Langefeld, Carl D, Langenberg, Claudia, Launer, Lenore J, Lee, Jin‐Moo, Lemmens, Robin, Leys, Didier, Lewis, Cathryn M, Lin, Wei‐Yu, Lindgren, Arne G, Lorentzen, Erik, Magnusson, Patrik K, Maguire, Jane, Manichaikul, Ani, McArdle, Patrick F, Meschia, James F, Mitchell, Braxton D, Mosley, Thomas H, Nalls, Michael A, Ninomiya, Toshiharu, O’Donnell, Martin J, Pulit, Sara L, Rannikmäe, Kristiina, Rexrode, Kathryn M, Rice, Kenneth, Rich, Stephen S, Rost, Natalia S, Rothwell, Peter M, Rundek, Tatjana, Sacco, Ralph L, Sakaue, Saori, Sale, Michele M, Salomaa, Veikko, Sapkota, Bishwa R, Schmidt, Reinhold, Schmidt, Carsten O, Schminke, Ulf, Sharma, Pankaj, Slowik, Agnieszka, Sudlow, Cathie LM, Tanislav, Christian, Tatlisumak, Turgut, Taylor, Kent D, Thijs, Vincent NS, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Tiedt, Steffen, Tzourio, Christophe, van Duijn, Cornelia M, Walters, Matthew, Wareham, Nicholas J, Wassertheil‐Smoller, Sylvia, Wilson, James G, Yusuf, Salim, Amin, Najaf, Aparicio, Hugo S, Arnett, Donna K, Attia, John, Beiser, Alexa S, Berr, Claudine, Buring, Julie E, Bustamante, Mariana, Caso, Valeria, Cheng, Yu‐Ching, Hoan Choi, Seung, Chowhan, Ayesha, Cullell, Natalia, Dartigues, Jean‐François, Delavaran, Hossein, Delgado, Pilar, Dörr, Marcus, Engström, Gunnar, Ford, Ian, Gurpreet, Wander S, Hamsten, Anders, Heitsch, Laura, Hozawa, Atsushi, Ibanez, Laura, Ilinca, Andreea, Ingelsson, Martin, Iwasaki, Motoki, Jackson, Rebecca D, Jood, Katarina, Jousilahti, Pekka, Kaffashian, Sara, Kalra, Lalit, Kamouchi, Masahiro, Kitazono, Takanari, Kjartansson, Olafur, Kloss, Manja, Koudstaal, Peter J, Krupinski, Jerzy, Labovitz, Daniel L, Laurie, Cathy C, Levi, Christopher R, Li, Linxin, Lind, Lars, Lindgren, Cecilia M, Lioutas, Vasileios, Mei Liu, Yong, Lopez, Oscar L, Makoto, Hirata, Martinez‐Majander, Nicolas, Matsuda, Koichi, Minegishi, Naoko, Montaner, Joan, Morris, Andrew P, Muiño, Elena, Müller‐Nurasyid, Martina, Norrving, Bo, Ogishima, Soichi, Parati, Eugenio A, Reddy Peddareddygari, Leema, Pedersen, Nancy L, Pera, Joanna, Perola, Markus, Pezzini, Alessandro, Pileggi, Silvana, Rabionet, Raquel, Riba‐Llena, Iolanda, Ribasés, Marta, Romero, Jose R, Roquer, Jaume, Rudd, Anthony G, Sarin, Antti‐Pekka, Sarju, Ralhan, Sarnowski, Chloe, Sasaki, Makoto, Satizabal, Claudia L, Satoh, Mamoru, Sattar, Naveed, Sawada, Norie, Sibolt, Gerli, Sigurdsson, Ásgeir, Smith, Albert, Sobue, Kenji, Soriano‐Tárraga, Carolina, Stanne, Tara, Colin Stine, O, Stott, David J, Strauch, Konstantin, Takai, Takako, Tanaka, Hideo, Tanno, Kozo, Teumer, Alexander, Tomppo, Liisa, Torres‐Aguila, Nuria P, Touze, Emmanuel, Tsugane, Shoichiro, Uitterlinden, Andre G, Valdimarsson, Einar M, van der Lee, Sven J, Völzke, Henry, Wakai, Kenji, Weir, David, Williams, Stephen R, Wolfe, Charles DA, Wong, Quenna, Xu, Huichun, Yamaji, Taiki, Sanghera, Dharambir K, Melander, Olle, Jern, Christina, Strbian, Daniel, Fernandez‐Cadenas, Israel, Longstreth, W T, Rolfs, Arndt, Hata, Jun, Woo, Daniel, Rosand, Jonathan, Pare, Guillaume, Hopewell, Jemma C, Saleheen, Danish, Stefansson, Kari, Worrall, Bradford B, Kittner, Steven J, Seshadri, Sudha, Fornage, Myriam, Markus, Hugh S, Howson, Joanna MM, Kamatani, Yoichiro, Debette, Stephanie, and Dichgans, Martin

Published
2022
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6. Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial

Author

Al-Shahi Salman, Rustam, Keerie, Catriona, Stephen, Jacqueline, Lewis, Steff, Norrie, John, Dennis, Martin S., Newby, David E., Wardlaw, Joanna M., Lip, Gregory Y.H., Parry-Jones, Adrian, White, Philip M., Baigent, Colin, Lasserson, Dan, Oliver, Colin, O'Mahony, Fiach, Amoils, Shannon, Bamford, John, Armitage, Jane, Emberson, Jonathan, Rinkel, Gabriël J.R., Lowe, Gordon, Innes, Karen, Adamczuk, Kasia, Dinsmore, Lynn, Drever, Jonathan, Milne, Garry, Walker, Allan, Hutchison, Aidan, Williams, Carol, Fraser, Ruth, Anderson, Rosemary, Covil, Kate, Stewart, Kelly, Rees, Jessica, Hall, Peter, Bullen, Alistair, Stoddart, Andrew, Moullaali, Tom J., Palmer, Jeb, Sakka, Eleni, Perthen, Joanne, Lyttle, Nicola, Samarasekera, Neshika, MacRaild, Allan, Burgess, Seona, Teasdale, Jessica, Coakley, Michelle, Taylor, Pat, Blair, Gordon, Whiteley, William, Shenkin, Susan, Clancy, Una, Macleod, Malcolm, Sutherland, Rachel, Moullaali, Tom, Barugh, Amanda, Lerpiniere, Christine, Moreton, Fiona, Fethers, Nicholas, Anjum, Tal, Krishnan, Manju, Slade, Peter, Storton, Sharon, Williams, Marie, Davies, Caroline, Connor, Lynda, Gainard, Glyn, Murphy, Carl, Barber, Mark, Esson, Derek, Choulerton, James, Shaw, Louise, Lucas, Suzanne, Hierons, Sarah, Avis, Joanne, Stone, Andrew, Gbadamoshi, Lukuman, Costa, Telma, Pearce, Lauren, Harkness, Kirsty, Richards, Emma, Howe, Jo, Kamara, Christine, Lindert, Ralf, Ali, Ali, Rehan, Jahanzeb, Chapman, Sarah, Edwards, Maria, Bathula, Raj, Cohen, David, Devine, Joseph, Mpelembue, Mushiya, Yesupatham, Priya, Chhabra, Swati, Adewetan, Gbadebo, Ballantine, Robert, Brooks, Daniel, Smith, Gemma, Rogers, Gill, Marsden, Stuart, Clark, Sarah, Wilkinson, Ami, Brown, Ellen, Stephenson, Lynsey, Nyo, Khin, Abraham, Annie, Pai, Yogish, Shim, Gek, Baliga, Vidya, Nair, Anand, Robinson, Matthew, Hawksworth, Catherine, Greig, Jill, Alam, Irfan, Nortcliffe, Tonicha, Ramiz, Ridha, Shaw, Ryan, Lee, Stephanie, Marsden, Tracy, Perez, Jane, Birleson, Emily, Yadava, Rajendra, Sangombe, Mirriam, Stafford, Sam, Hughes, Tom, Knibbs, Lucy, Morse, Bethan, Schwarz, Stefan, Jelley, Benjamin, White, Susan, Richard, Bella, Lawson, Heidi, Moseley, Sally, Tayler, Michelle, Edwards, Mandy, Triscott, Claire, Wallace, Rebecca, Hall, Angela, Dell, Amanda, Rashed, Khalid, Board, Sarah, Buckley, Clare, Tanate, Alfonso, Pitt-Kerby, Tressy, Beesley, Kate, Perry, Jess, Hellyer, Christine, Guyler, Paul, Menon, Nisha, Tysoe, Sharon, Prabakaran, Raji, Cooper, Martin, Rajapakse, Anoja, Wynter, Inez, Smith, Susan, Weir, Nic, Boxall, Cherish, Yates, Hannah, Smith, Simon, Crawford, Pamela, Marigold, James, Smith, Fiona, Harvey, Jake, Evans, Sue, Baldwin, Laura, Hammond, Sarah, Mudd, Paul, Bowring, Angela, Keenan, Samantha, Thorpe, Kevin, Haque, Mohammad, Taaffe, Joanne, Temple, Natalie, Peachey, Tracey, Wells, Kim, Haines, Fiona, Butterworth-Cowin, Nicola, Horne, Zoey, Licenik, Radim, Boughton, Hayley, England, Timothy, Hedstrom, Amanda, Menezes, Brian, Davies, Ruth, Johnson, Venetia, Whittingham-Jones, Simon, Werring, David, Obarey, Sabaa, Watchurst, Caroline, Ashton, Amy, Feerick, Shez, Francia, Nina, Banaras, Azra, Epstein, Daniel, Marinescu, Marilena, Williams, Annick, Robinson, Anna, Humphries, Fiona, Anwar, Ijaz, Annamalai, Arunkumar, Crawford, Susan, Collins, Vicky, Shepherd, Lorna, Siddle, Elaine, Penge, Justin, Qureshi, Sam, Krishnamurthy, Vinodh, Papavasileiou, Vasileios, Waugh, Dean, Veraque, Emelda, Douglas, Nathan, Khan, Numan, Ramachandran, Sankaranarayanan, Sommerville, Peter, Rudd, Anthony, Kullane, Sagal, Bhalla, Ajay, Birns, Jonathan, Ahmed, Rowshanara, Gibbons, Meegan, Klamerus, Eva, Cendreda, Benjie, Muir, Keith, Day, Nicola, Welch, Angela, Smith, Wilma, Elliot, Jennifer, Eltawil, Salwa, Mahmood, Ammad, Hatherley, Kim, Mitchell, Shirley, Bains, Harjit, Quinn, Lauren, Teal, Rachel, Gbinigie, Ivie, Harston, George, Mathieson, Phil, Ford, Gary, Schulz, Ursula, Kennedy, James, Nagaratnam, Kirubananthan, Bangalore, Kiran, Bhupathiraju, Neelima, Wharton, Chris, Fotherby, Ken, Nasar, Ahmad, Stevens, Angie, Willberry, Angela, Evans, Rachel, Rai, Baljinder, Blake, Chloe, Thavanesan, Kamy, Hann, Gail, Changuion, Tanith, Nix, Sara, Whiting, Amanda, Dharmasiri, Michelle, Mallon, Louise, Keltos, Marketa, Smyth, Nigel, Eglinton, Charlotte, Duffy, John, Tone, Ela, Sykes, Lucy, Porter, Emily, Fitton, Carolyn, Kirkineziadis, Nikolaos, Cluckie, Gillian, Kennedy, Kate, Trippier, Sarah, Williams, Rebecca, Hayter, Elizabeth, Rackie, James, Patel, Bhavini, Rita, Ghatala, Blight, Adrian, Jones, Val, Zhang, Liqun, Choy, Lillian, Pereira, Anthony, Clarke, Brian, Al-Hussayni, Samer, Dixon, Lynn, Young, Andrew, Bergin, Adrian, Broughton, David, Raghunathan, Senthil, Jackson, Benjamin, Appleton, Jason, Wilkes, Gwendoline, Buck, Amanda, Richardson, Carla, Clarke, Judith, Fleming, Lucy, Squires, Gemma, Law, Zhe, Hutchinson, Camille, Cvoro, Vera, Couser, Mandy, McGregor, Amanda, McAuley, Sean, Pound, Susan, Cochrane, Patricia, Holmes, Clare, Murphy, Peter, Devitt, Nicola, Osborn, Mairead, Steele, Amy, Guthrie, Lucy Belle, Smith, Elizabeth, Hewitt, Jonathan, Chaston, Natalie, Myint, Min, Smith, Andrew, Fairlie, Louise, Davis, Michelle, Atkinson, Beth, Woodward, Stephen, Hogg, Valerie, Fawcett, Michelle, Finlay, Louise, Dixit, Anand, Cameron, Eleanor, Keegan, Breffni, Kelly, Jim, Concannon, Dónal, Dutta, Dipankar, Ward, Deborah, Glass, Jon, O'Connell, Susan, Ngeh, Joseph, O'Kelly, Alison, Williams, Emma, Ragab, Suzanne, Jenkinson, Damian, Dube, Judith, Gleave, Laura, Leggett, Jacqui, Kissoon, Nisha, Southern, Louise, Naghotra, Utpal, Bokhari, Maria, McClelland, Beverley, Adie, Katja, Mate, Abhijit, Harrington, Frances, James, Ali, Swanson, Elizabeth, Chant, Terri, Naccache, Miriam, Coutts, Abbie, Courtauld, Gillian, Whurr, Sarah, Webber, Sue, Shead, Emily, Luder, Robert, Bhargava, Maneesh, Murali, Elodie, Cuenoud, Larissa, Pasco, Kath, Speirs, O, Chapman, Lianne, Inskip, Linda, Kavanagh, Lisa, Srinivasan, Meena, Motherwell, Nichola, Mukherjee, Indranil, Tonks, Louise, Donaldson, Denise, Button, Heather, Wilcox, Rebecca, Hurford, Fran, Logan, Rachel, Taylor, Andy, Arden, Tracie, Carpenter, Michael, Datta, Prabal, Zahoor, Tajammal, Jackson, Linda, Needle, Ann, Stanners, Andrew, Ghouri, Imran, Exley, Donna, Akhtar, Salman, Brooke, Hollie, Beadle, Shannen, O'Brien, Eoin, Francis, Jobbin, McGee, Joanne, Amis, Elaine, Mitchell, Jennifer, Finlay, Sarah, Sinha, Devesh, Manoczki, Csilla, King, Sam, Tarka, James, Choudhary, Sumita, Premaruban, Jegamalini, Sutton, Dorothy, Kumar, Pradeep, Culmsee, Charlotte, Winckley, Caroline, Davies, Holly, Thatcher, Hilary, Vasileiadis, Evangelos, Aweid, Basaam, Holden, Melinda, Mason, Cathy, Hlaing, Thant, Madzamba, Gladys, Ingram, Tanya, Linforth, Michelle, Cullen, Claire, Thomas, Nibu, France, John, Saulat, Afaq, Bhaskaran, Biju, Fitzell, Pauline, Horan, Kathleen, Manyoni, Catherine, Garfield-Smith, Josie, Griffin, Hannah, Atkins, Stacey, Redome, Joan, Muddegowda, Girish, Maguire, Holly, Barry, Adrian, Abano, Nenette, Varquez, Resti, Hiden, Joanne, Lyjko, Susan, Remegoso, Alda, Finney, Kay, Butler, Adrian, Strecker, Martin, MaCleod, Mary Joan, Irvine, Janice, Nelson, Sandra, Guzmangutierrez, German, Furnace, Jacqueline, Taylor, Vicky, Ramadan, Hawraman, Storton, Kim, Hassan, Sohail, Abdus Sami, Eman, Bellfield, Ruth, Stewart, Kelvin, Quinn, Outi, Patterson, Chris, Emsley, Hedley, Gregary, Bindu, Ahmed, Shakeel, Patel, Shakeelah, Raj, Sonia, Sultan, Sulaiman, Wright, Fiona, Langhorne, Peter, Graham, Ruth, Quinn, Terry, and McArthur, Kate

Published
2021
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8. Barriers to Effective Prehospital and Hyperacute Stroke Care in India: A Physician Perspective.

Author

Abraham, Siju V., Joy, Anita, Sahu, Ankit Kumar, Ravindra, Prithvishree, Dhar, Shirshendu, Teja, Ravi, Krishnan, S. Vimal, Liu, Renyu, Rudd, Anthony George, and Ford, Gary A.

Subjects
STROKE treatment, PSYCHOLOGY of physicians, HEALTH services accessibility, COMMUNITY health services, HEALTH literacy, ACUTE diseases, PROPRIETARY hospitals, QUESTIONNAIRES, INTERVIEWING, COMPUTED tomography, HEALTH insurance, EMERGENCY medicine, PHYSICIANS' attitudes, EMERGENCY medical services, DESCRIPTIVE statistics, MAGNETIC resonance imaging, SURVEYS, INFORMATION services, INTRAVENOUS therapy, RESEARCH methodology, METROPOLITAN areas, AMBULANCES, STROKE, DELAYED diagnosis, TREATMENT delay (Medicine), BLOOD sugar monitoring, DISEASE complications
Abstract

Introduction: The incidence of stroke is increasing in India. Prehospital stroke care is crucial for reducing stroke morbidity and mortality, but its implementation in India faces several challenges. Limited original research exists on prehospital stroke care in India, making it essential to identify the problems in implementing effective prehospital stroke care. Methods: A web-based survey was conducted among registered medical practitioners in India who treat acute stroke. The survey questionnaire was developed in English and included 26 questions divided into five parts: questions about the physician's practice setup/hospital in India, perception of community awareness, existing prehospital care/systems, in-hospital stroke care availability, and specific issues faced. Results: Eighty-three doctors in India participated in the survey (43% response rate). Most of the respondents worked in private hospitals (68%) and urban areas (76%). While 89% of hospitals had ambulance services, over 33% reported that patients had to pay for ambulance transport. Among respondents, 12% reported a community stroke care network, with infrequent prehospital procedures such as random blood glucose measurement (22%), stroke identification (15.7%), "last seen normal" documentation (14.5%), and low prehospital notification to hospitals (5%). Delays in referral from peripheral centers were reported by 73% of respondents. Most hospitals had standard operating procedures (SOPs) (84%), computed tomography (CT) (94%), magnetic resonance imaging (MRI) (85%), and offered intravenous thrombolysis (IVT) (77%). However, 24 h availability of CT was reported only by 6%, MRI by 19% and IVT by 12%. Nearly half (45%) reported treatment with thrombolysis was not covered by insurance. Mechanical thrombectomy was available in 34% of hospitals and 63% of hospitals conducted in-hospital audits for stroke patients. Conclusions: The capabilities of stroke-catering hospitals in urban settings are encouraging, with many having SOPs, imaging capabilities, and thrombolysis and mechanical thrombectomy services. However, there is much room for improvement, in making the essential stroke care services financially accessible to all and available around the clock. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Author

Dennis, Martin, Mead, Gillian, Forbes, John, Graham, Catriona, Hackett, Maree, Hankey, Graeme J, House, Allan, Lewis, Stephanie, Lundström, Erik, Sandercock, Peter, Innes, Karen, Williams, Carol, Drever, Jonathan, Mcgrath, Aileen, Deary, Ann, Fraser, Ruth, Anderson, Rosemary, Walker, Pauli, Perry, David, Mcgill, Connor, Buchanan, David, Chun, Yvonne, Dinsmore, Lynn, Maschauer, Emma, Barugh, Amanda, Mikhail, Shadia, Blair, Gordon, Hoeritzauer, Ingrid, Scott, Maggie, Fraser, Greig, Lawrence, Katherine, Shaw, Alison, Williamson, Judith, Burgess, David, Macleod, Malcolm, Morales, Dan, Sullivan, Frank, Brady, Marian, French, Ray, Van Wijck, Frederike, Watkins, Caroline, Proudfoot, Fiona, Skwarski, Joanna, Mcgowan, Diane, Murphy, Rachael, Burgess, Seona, Rutherford, William, Mccormick, Katrina, Buchan, Ruaridh, Macraild, Allan, Paulton, Ruth, Fazal, Adnan, Taylor, Pat, Parakramawansha, Ruwan, Hunter, Neil, Perry, Jack, Bamford, John, Waugh, Dean, Veraque, Emelda, Bedford, Caroline, Kambafwile, Mary, Idrovo, Luis, Makawa, Linetty, Smalley, Paula, Randall, Marc, Thirugnana-Chandran, Tharani, Hassan, Ahamad, Vowden, Richard, Jackson, Joanne, Bhalla, Ajay, Rudd, Anthony, Tam, Chi Kai, Birns, Jonathan, Gibbs, Charlotte, Lee Carbon, Leonie, Cattermole, Elizabeth, Marks, Katherine, Cape, Angela, Hurley, Lisa, Kullane, Sagal, Smyth, Nigel, Eglinton, Charlotte, Wilson, Jennifer, Giallombardo, Elio, Frith, Angela, Reidy, Paul, Pitt, Matthew, Sykes, Lucy, Dellafera, Deborah, Croome, Victoria, Kerwood, Lauriane, Hancevic, Mirea, Narh, Christina, Merritt, Carley, Duffy, John, Cooke, Duncan, Willson, Juliet, Ali, Ali, Naqvi, Aaizza, Kamara, Christine, Bowler, Helen, Bell, Simon, Jackson, Tracy, Harkness, Kirsty, Stocks, Kathy, Duty, Suzanna, Doyle, Clare, Dunn, Geoffrey, Endean, Keith, Claydon, Fiona, Richards, Emma, Howe, Jo, Lindert, Ralf, Majid, Arshad, Dakin, Katy, Maatouk, Ahmad, Barron, Luke, Meegada, Madana, Rana, Pratap, Nair, Anand, Brighouse-Johnson, Christine, Greig, Jill, Kyu, Myint, Prasad, Sanjeev, Robinson, Matthew, Alam, Irfan, Mclean, Belinda, Greenhalgh, Lindsay, Ahmed, Zenab, Roffe, Christine, Brammer, Susan, Beardmore, Carole, Finney, Kay, Barry, Adrian, Hollinshead, Paul, Grocott, Jeanette, Maguire, Holly, Natarajan, Indira, Chembala, Jayan, Sanyal, Ranjan, Lijko, Sue, Abano, Nenette, Remegoso, Alda, Ferdinand, Phillip, Stevens, Stephanie, Varquez, Resti, Causley, Chelsea, Butler, Adrian, Whitmore, Philip, Stephen, Caroline, Carpio, Racquel, Hiden, Joanne, Muddegowda, Girish, Denic, Hayley, Sword, Jane, Curwen, Ross, James, Martin, Mudd, Paul, Hall, Fiona, Cageao, Julie, Keenan, Samantha, Roughan, Caroline, Kingwell, Hayley, Hemsley, Anthony, Lohan, Christoph, Davenport, Sue, Bowring, Angela, Chapter, Tamika, Hough, Max, Strain, David, Gupwell, Karin, Miller, Keniesha, Goff, Anita, Cusack, Ellie, Todd, Shirley, Partridge, Rebecca, Jennings, Georgiana, Thorpe, Kevin, Stephenson, Jacquelyn, Littlewood, Kelly, Barber, Mark, Brodie, Fiona, Marshall, Steven, Esson, Derek, Coburn, Irene, Mcinnes, Caroline, Ross, Fiona, Bowie, Emma, Barcroft, Heather, Withers, Victoria, Miller, Laura, Willcoxson, Paul, Donninson, Michelle, Evans, Richard, Daniel, Di, Coyle, John, Keeling, Michael, Wanklyn, Peter, Elliott, Mark, Wightman, John, Iveson, Elizabeth, Dyer, Natasha, Porteous, Anne-Marie, Haritakis, Monica, Ward, Mandy, Doughty, Lucy, Carr, Lisa, O Neill, Mark, Anazodo, Cosmas, Wood, Paul, Cottrell, Poppy, Donne, Cheryl, Rodriguez, Romina, Mir, Ruhail, Westmoreland, Jax, Bell, Judith, Emms, Christopher, Wright, Lorraine, Clark Brown, Pearl, Bamford, Elizabeth, Stanners, Andrew, Carpenter, Mike, Datta, Prabal, Davey, Richard, Needle, Ann, Eastwood, Marjorie Jane, Razik, Fathima Zeena, Ghouri, Imran, Bateman, Gavin, Archer, Judy, Balasubramanian, Venkatesh, Bowers, Richard, Ball, Julie, Benton, Louise, Jackson, Linda, Ellam, Julie, Norton, Kate, Guyler, Paul, Dowling, Terry, Tysoe, Sharon, Harman, Paula, Kundu, Ashish, Omodunbi, Ololade, Loganathan, Thayalini, Chandler, Stuart, Noor, Shanas, Siddiqui, Anwer, Siddiqui, Amber, Kunhunny, Swapna, Sinha, Devesh, Sheppard, Martin, Rashmi, Sindhu, France, Elena, Orath Prabakaran, Rajalakshmi, Wilson, Laura, Ropun, Amiirah, Kelavkar, Shyam, Ng, Kheng Xiong, Kamuriwo, Lucy, Shah, Sweni, Mangion, David, Constantin, Camen, De Michele Hock, Luigi, Hardwick, Anne, Borley, Jayne, Markova, Skarlet, Netherton, Kimberley, Lawrence, Tara, Fletcher, Jo, Spencer, Rebecca, Palmer, Helen, Cullen, Claire, Hamill, Dolores, Durairaj, Ramesh, Mellor, Zoe, Fluskey, Tanya, Wood, Diane, Keeling, Alison, Hankin, Victoria, Peters, Jennifer, Shackcloth, Daniela, Hlaing, Thant, Tangney, Rebecca, Ewing, Jordan, Harrison, Melanie, Stevenson, Sarah, Sutton, Victoria, Soliman, Mohamed, Hindle, Julia, Watson, Elizabeth, Hewitt, Claire, Butler, Susie, Wahishi, Ibrahim, Arif, Sarwat, Fields, Amy, Sharma, Jagdish, Brown, Rose, Taylor, Caroline, Bell, Sarah, Leach, Simon, Patterson, Chris, Khan, Sophia, Wilson, Helen, Price, Joanne, Ramadan, Hawraman, Maguire, Stuart, Bellfield, Ruth, Hooley, Michaela, Hamid, Umair, Gaba, Waqar, Ghulam, Robina, Masters, Leslie, Quinn, Outi, Sekaran, Lakshmanan, Tate, Margaret, Mohammed, Niaz, Bharaj, Kiranjit, Justin, Frances, Pattni, Rajan, Alwis, Lanka, Sethuraman, Sakthivel, Robinson, Rianne, Eldridge, Lianne, Mintias, Susan, Chauhan, Meena, Tam, Chi-Kai, Palmones, Jeremias, Holmes, Clare, Guthrie, Lucy Belle, Osborn, Mairead, Ball, Lindsay, Caine, Sarah, Steele, Amy, Murphy, Peter, Devitt, Nikki, Leonard, Jayne, Patel, Ronak, Penwarden, Ian, Dodd, Emily, Holloway, Amy, Baker, Pauline, Clarke, Samantha, Williams, Sandra, Dow, Lindsey, Wynn-Williams, Roland, Kennedy, James, Teal, Rachel, Schulz, Ursula, Ford, Gary, Mathieson, Philip, Reckless, Ian, Deveciana, Ana, Mccann, Paige, Cluckie, Gillian, Howell, Geoffrey, Ayer, Jonathan, Moynihan, Barry, Ghatala, Rita, Clarke, Brian, Cloud, Geoffrey, Patel, Bhavini, Khan, Usman, Al-Samarrai, 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Willberry, Angela, Morgan, Debbie, Butler, Donna, Sahota, Gurminder, Kauldhar, Kelly, Ahmad, Nasar, Stevens, Angela, Das, Saugata, Bruce, David, Pai, Yogish, Nyo, Khin, Stephenson, Lynsey, Nendick, Richard, Rogers, Gill, Dhakal, Mahesh, Dima, Sofia, Brown, Ellen, Clayton, Susan, Gamble, Penny, Naeem, Muhammad, Hayman, Rachel, Burnip, Rachel, Earnshaw, Philip, Hargroves, David, Ransom, Barbara, Rudenko, Hannah, Balogun, Ibrahim, Griffiths, Kirsty, Mears, Kim, Webb, Tom, Cowie, Linda, Hammond, Tessa, Thomson, Audrey, Ceccarelli, Daniela, Chattha, Navraj, Beranova, Eva, Verrion, Anna, Gillian, Andrew, Schumacher, Natasha, Bahk, Anna, Walker, Susannah, Cvoro, Vera, Chapman, Nicola, Pound, Susan, Cain, Rebecca, Mcauley, Sean, Couser, Mandy, Simpson, Maria, Tachtatzis, Athan, Ullah, Khalil, Sims, Don, Jones, Rachael, Smith, Jonathan, Tongue, Rebecca, Willmot, Mark, Sutton, Claire, Littleton, Edward, Khaira, Jattinder, Maiden, Susan, Cunningham, James, Green, Carole, Chin, Yin-May, Bates, Michelle, Ahlquist, Katherine, Kane, Ingrid, Breeds, Joanna, Sargent, Tenesa, Latter, Laura, Pitt Ford, Alexandra, Gainsborough, Nicola, Levett, Tom, Thompson, Philip, Barbon, Emma, Dunne, Angela, Hervey, Simon, Ragab, Suzanne, Sandell, Tracy, Dickson, Christine, Dube, Judith, Power, Sharon, Evans, Nick, Wadams, Beverley, Elitova, Savina, Aubrey, Beth, Garcia, Tatiana, Mcilmoyle, James, Jeffs, Carol, Dickinson, Christina, Ahmed, Anis, Kumar, Sanjeev, Frudd, Julie, Armer, Charlotte, Potter, Andrew, Donaldson, Stacey, Howard, Joanne, Jones, Kirsty, Dhar, Saikat, Collas, David, Sundayi, Saul, Denham, Lynn, Oza, Deepali, Walker, Elaine, Bhandari, Mohit, Ispoglou, Sissy, Evans, Rachel, Sharobeem, Kamel, Walton, Elaine, Shanu, Steven, Hayes, Anne, Howard-Brown, Jennifer, Billingham, Steven, Weir, Nic, Pressly, Vanessa, Wood, Emma, Howard, Gabriella, Burton, Holly, Crawford, Pam, Egerton, Shuna, Evans, Sue, Hakkak, Jasmine, Andrews, Janet, Lampard, Rebecca, Allen, Christopher, Walters, Ashleigh, Said, Rasha, Marigold, James Richard, Tsang, Sau-Mon, Creeden, Robyn, Cox, Chloe, Smith, Simon, Gartrell, Imogen, Smith, Fiona, Jenkins, Colin, Pryor, Joanna, Hedges, Andrew, Price, Fiona, Moseley, Linda, Mercer, Lily, Hughes, Claire, Azim, Abul, White, Julie, Krasinska-Chavez, Milena, Chaplin, Shaun, Curtis, James, Singh, Deepwant, Imam, Javed, Nicolson, Anne, Alam, Sajid, Whitworth, Simon, Wood, Lisa, Warburton, Elizabeth, Kelly, Siobhan, Mcgee, Joanne, Markus, Hugh, Chandrasena, Denish, Hayden, Derek, Sesay, Juliana, Hayhoe, Helen, Bolton, Mark, Macdonald, Jane, Mitchell, Jenny, Farron, Charlotte, Amis, Elaine, Day, Diana, Culbert, Ainsley, Espanol, Ailene, Hannon, Niamh, Handley, Dominic, Finlay, Sarah, Crisp, Sarah, Whitehead, Lynne, Francis, Jobbin, Oconnell, Janice, Osborne, Emily, Beard, Rod, Krishnamurthy, Ramesh, Mokoena, Langanani, Sattar, Naweed, Myint, Min, Edwards, Michelle, Smith, Andrew, Corrigan, Paul, Byrne, Anthony, Blackburn, Joanne, Mcghee, Caroline, Smart, Amanda, Donaldson, Fiona, Copeland, Claire, Wilson, Jill, Scott, Rhona, Fitzsimmons, Paul, Lopez, Paula, Wilkinson, Mark, Manoj, Aravindakshan, Cox, Penelope, Trainor, Leona, Fletcher, Glyn, Denny, Lisa, Kavanagh, Karen, Allsop, Hannah, Emsley, Hedley, Sultan, Sulaiman, Mcloughlin, Alison, Walmsley, Benjamin, Hough, Louise, Ahmed, Shakeel, Doyle, Donna, Gregary, Bindu, Raj, Sonia, Nagaratnam, Kirubananthan, Mannava, Neelima, Haque, Nyla, Shields, Norma, Preston, Kate, Mason, Geraldine, Short, Kirsty, Lumsdale, Gemma, Uitenbosch, Giulia, Sukys, Ugnius, Valentine, Stacey, Jarrett, David, Dodsworth, Kerry, Wands, Mary, Khan, Nisa, Tandy, Jane, Watkinson, Catrin, Golding, Wendy, Butler, Rebecca, Williams, Max, Davies, Yasmin, Yip, Keith, James, Claire, Suttling, Anne, Maney, Aditya, Gamble, Giles Edward, Hague, Adam, Charles, Bethan, Blane, Sujata, Duran, Beatriz, Lambert, Caroline, Stagg, Katherine, Whiting, Robert, Homan, Jane E, Brown, Sarah, Hussain, Malik, Harvey, Miriam, 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Mark, Aruldoss, Prabhu, Cook, Angela, Crabtree, Karen, Dabbagh, Sura, Black, Toby, Clarke, Caroline, Mead, Denise, Fennelly, Ruth, Anthony, Alpha, Nardone, Linda, Dimartino, Victoria, Tribbeck, Michele, Broughton, David, Tryambake, Dinesh, Dixon, Lynn, Skotnicka, Agnieszka, Thompson, Jane, Whitehouse, Sarah, Sigsworth, Andrew, Wong, Jason, Annamalai, Arunkumar, Pagan, Julie, Affley, Brendan, Sunderland, Caroline, Goldenberg, Lynda, Khan, Atif, Wilkinson, Peter, Nari, Raad, Abbott, Lucy, Young, Emma, Shakhon, Amritpal, Lock, Sally, Stewart, Jack, Pereira, Rita, Dsouza, Margaret, Dunn, Sally, Mckenna, Anne-Marie, Cron, Nina, Kidd, Michelle, Hull, Grace, Bunworth, Kerry, Drummond, Graham, Mahawish, Karim, Hayes, Nicola, Connell, Lynne, Simpson, Jennifer, Penney, Helen, Punekar, Shuja, Nevinson, Joanne, Wareing, William, Ward, Jacqueline, Greenwood, Richard, Austin, Duncan, Banaras, Azra, Hogan, Carolin, Corbett, Thomas, Oji, Nnebuife, Elliott, Emma, Brezitski, Maria, Passeron, Nathalie, 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Auld, Grace, Song, Anna, Tarkas, Tillana, Kabash, Hashim, and Hungwe, Rumbi

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2019
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10. Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study

Author

Aeron-Thomas, John, Aghoram, Prasanna, Amis, Elaine, Anderton, Peter, Andole, Sreeman, Anwar, Ijaz, Bamford, John, Banaras, Azra, Barry, Aian, Bellfied, Ruth, Benford, Aienne, Bhalla, Ajay, Bhargava, Maneesh, Bhaskaran, Biju, Bhupathiraju, Neelima, Birns, Jonathan, Blight, Aian, Bowring, Angie, Brown, Ellen, Bruce, David, Buck, Amanda, Bunworth, Kerry, Burger, Ilse, Burgess, Laura, Burn, Mathew, Burssens, Evelyn, Burton, Mauian, Butler, Nicola, Button, Denise, Carpenter, Michael, Chadha, Dinesh, Chatterjee, Kausik, Choy, Lillian, Cohen, David, Connell, Lynne, Cooper, Martin, Corrigan, John, Cotterill, Donna, Courtauld, Gillian, Crawford, Susan, Cullen, Claire, Dani, Krishna, Daniel, Amelia, Datta, Prabel, Davis, Michelle, Day, Nicola, Doherty, Mandy, Douglas, Catherine, Dunne, Karen, Edwards, Collette, Eglinton, Charlotte, Elmarimi, Abduelbaset, Emsley, Hedley, England, Timothy, Epstein, Daniel, Erande, Renuka, Esisi, Bernard, Evans, Rachel, Farren, Pamela, Fitzell, Pauline, Fletcher, Glyn, Gallifent, Rachel, Gascoyne, Rachel, Giallombardo, Elio, Gregary, Bindu, Gunathilagan, Gunaratam, Guyler, Paul, Hairsine, Brigid, Haley, Michael, Hardwick, Anne, Hargroves, David, Harrington, Frances, Hedstrom, Amanda, Holmes, Clare, Hussein, Senussi, Ingram, Tanya, Ispoglou, Sissi, Iveson, Liz, Johnson, Venetia, Justin, Frances, Kausar, Shahid, Kee, Karen, Keeling, Michael, Khan, Shagufta, Kieliszkowska, Agnieszka, Kingwell, Hayley, Krishnamurthy, Vinodh, Kullane, Sagal, Kumar, Balakrishna, Leach, Simon, Leason, Sana, Lopez, Paula, Luder, Robert, Madigan, Barbara, Maguire, Stuart, Maguire, Holly, Mahawish, Karim, Makawa, Linetty, Mamun, Maam, Manawadu, Dulka, Mangion, David, Manoj, Aravindakshan, Mansoor, Syed, Marsden, Tracy, Marsh, Rachel, Mashate, Sheila, McCormick, Michael, McGolick, Clare, McKee, Madeleine, Mckenzie, Emma, Meenakishundaram, Sanjeevikumar, Mellor, Zoe, Misra, Amulya, Mistri, Amit, Mohd Nor, Azlisham, Mpelembue, Mushiya, Murphy, Peter, Nallasivam, Arumug, Needle, Ann, Nguyen, Vinh, O'Connell, Janice, O'Mahony, Paul, Okwera, James, Orefo, Chukwuka, Owusu-Agyei, Peter, Parry, Anthea, Parry-Jones, Adrian, Pasco, Kath, Patterson, Chris, Peixoto, Cassilda, Perez, Jane, Persad, Nicola, Porteous, Mia, Power, Michael, Price, Christopher, Proschel, Harald, Punekar, Shuja, Putterill, Janet, Randall, Marc, Redjep, Ozlem, Rehman, Habib, Richards, Emma, Riddell, Victoria, Roffe, Christine, Rogers, Gill, Rudd, Anthony, Saastamoinen, Kari, Sajid, Mahmud, Sandhu, Banher, Schofield, Christine, Scott, Jon, Sekaran, Lakshmanan, Sharma, Pankaj, Sharma, Jagdish, Sharpe, Simon, Smith, Matthew, Smith, Anew, Sprigg, Nikola, Staals, Julie, Steele, Amy, Storey, Gail, Storey, Kelley, Subramonian, Santhosh, Sword, Jane, Tallon, Grainne, Tan, Garryck, Tate, Margaret, Teke, Jennifer, Temple, Natalie, Thompson, Teresa, Tysoe, Sharon, Vahidassr, Djamil, van der Kwaak, Anouk, Veltkamp, Roland, Walstow, Deborah, Watchurst, Caroline, Watson, Fran, Waugh, Dean, Wilkinson, Peter, Wilson, David, Wilson-Owen, Sarah, Wroath, Belinda, Wynter, Inez, Young, Emma, Wilson, Duncan, Ambler, Gareth, Shakeshaft, Clare, Brown, Martin M, Charidimou, Andreas, Al-Shahi Salman, Rustam, Lip, Gregory Y H, Cohen, Hannah, Banerjee, Gargi, Houlden, Henry, White, Mark J, Yousry, Tarek A, Harkness, Kirsty, Flossmann, Enrico, Smyth, Nigel, Shaw, Louise J, Warburton, Elizabeth, Muir, Keith W, Jäger, Hans Rolf, and Werring, David J

Published
2018
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21. Expert opinions from the 2024 closed door round table discussion on improving stroke prehospital care globally.

Author

Liu, Renyu, Zhao, Jing, Pandian, Jeyaraj Durai, Ford, Gary A, Ji, Qiuhong, Abraham, Siju V., Ji, Xunming, and Rudd, Anthony

Subjects
STROKE, EMERGENCY medical services, TRANSIENT ischemic attack, STROKE units, YOUNG adults
Abstract

A closed-door round table discussion was held to address the need for improving stroke prehospital care globally. The discussion focused on key expert opinions and agreements, including the importance of rapid recognition and transfer to a hospital, the cost-effectiveness of improving prehospital care, the sharing of best practices, the development of specific guidelines for prehospital stroke care, the focus on onset to door time as a quality evaluation indicator, the need for prehospital stroke care research, the importance of funding and innovation, sustained collaboration, and the expansion of taskforces. The discussion also highlighted the need for prompt hospital transfer for patients ineligible for thrombolysis or thrombectomy and the management of minor strokes and transient ischemic attacks. The round table discussion provided valuable perspectives to inform future strategies for optimizing stroke prehospital care delivery and improving patient outcomes globally, with a particular emphasis on addressing the stroke burden in low- and middle-income countries. [Extracted from the article]

Published
2024
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22. Authors’ reply to Hill and Rudd

Author

Morris, Stephen, Hunter, Rachael M, Ramsay, Angus I G, Boaden, Ruth, McKevitt, Christopher, Perry, Catherine, Pursani, Nanik, Rudd, Anthony G, Turner, Simon J, Tyrrell, Pippa J, Wolfe, Charles D A, and Fulop, Naomi J

Published
2014

24. Kierkegaard on Hope and Faith.

Author

Rudd, Anthony

Subjects
*DESPAIR, *VIRTUE, *THEOLOGICAL virtues, *VIRTUES, *FAITH, *HOPE, *VIRTUE ethics
Abstract

Faith, hope and love have often been classed together in the Christian tradition as the three "theological virtues". Kierkegaard does not use that label for them, but he does have a good deal to say about all three. This paper starts by examining hope, arguing that there is an Aristotelian-style virtue relating to hope (a mean between wishful and depressive thinking) and that Kierkegaard could consistently recognize it as a secular virtue. However, his main discussions of hope as a positive state are in a religious context and relate it closely to faith and love; proper hope is a work of love and grounded in faith in God. I then argue that Kierkegaard's understanding of faith, hope and love is, in many respects, close to Aquinas' understanding of them as theological virtues (which differs in important ways from Aristotle's account of a virtue) and that, therefore, it is appropriate to see Kierkegaard's religious thought as lying within the tradition of virtue theory. The main difference between Aquinas and Kierkegaard here is that the former has an intellectualist and propositional account of faith which contrasts with the latter's affective and existential view of it. This means that hope and love are both closer to faith for Kierkegaard than they are for Aquinas, meaning that he has a tight account of the unity of the theological virtues. I conclude by discussing how both faith and hope operate as antidotes to despair in The Sickness Unto Death. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Cohort Profile: The Stroke in Sierra Leone (SISLE) Register.

Author

Youkee, Daniel, Marshall, Iain J, Fox-Rushby, Julia, Lisk, Durodami R, O'Hara, Jessica, Wang, Yanzhong, Rudd, Anthony, Wolfe, Charles D A, Deen, Gibrilla F, and Sackley, Catherine

Subjects
STROKE, DISEASE risk factors, NON-communicable diseases, ATRIAL fibrillation, STROKE units
Abstract

The Stroke in Sierra Leone (SISLE) Register is a prospective observational stroke register that aims to study stroke risk factors, patient care, and outcomes in Sierra Leone. The register recruited 986 patients with confirmed stroke from two hospitals in Freetown and collected data on various variables such as demographics, risk factors, stroke type, and mortality rates. The register has informed the development of a strategic action plan for non-communicable diseases in Sierra Leone and has led to the establishment of a specialized stroke unit. The data from the register are available for further research and collaboration. The register found that severe strokes occur in younger patients who were previously independent, and the case fatality rate is high. Functional improvement is most likely to occur between 7 and 90 days post-stroke. Risk factors such as hypertension, diabetes, dyslipidemia, and atrial fibrillation were identified. [Extracted from the article]

Published
2023
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26. Results of an international survey on the status of prehospital care.

Author

Rudd, Anthony G, Zhao, Jing, Ford, Gary, Melifonwu, Rita, Abraham, Siju V, Fisher, Marc, Andersen, Grethe, Waters, David, Li, Dou, and Liu, Renyu

Subjects
*EMERGENCY medical services, *STROKE units, *EMERGENCY medical technicians, *STROKE, *AMBULANCE service, *HIGH-income countries, *MIDDLE-income countries
Abstract

Background: Prehospital care including recognition of stroke symptoms by the public and professionals combined with an efficient and effective emergency medical service (EMS) is essential to increase access to effective acute stroke care. We undertook a survey to document the status of stroke prehospital care globally. Methods: A survey was distributed via email to the World Stroke Organization (WSO) members. Information was sought on the current status of stroke prehospital delay globally, including (1) ambulance availability and whether payment for use is required, (2) ambulance response times and the proportion of patients arriving at hospital by ambulance, (3) the proportion of patients arriving within 3 h and more than 24 h after symptom, (4) whether stroke care training of paramedics, call handlers, and primary care staff, (5) availability of specialist centers, and (6) the proportion of patients taken to specialist centers. Respondents were also asked to identify the top three changes in prehospital care that would benefit their population. Data were analyzed descriptively at both country and continent level. Results: Responses were received from 116 individuals in 43 countries, with a response rate of 4.7%. Most respondents (90%) reported access to ambulances, but 40% of respondents reported payment was required by the patient. Where an ambulance service was available (105 respondents) 37% of respondents reported that less than 50% of patients used an ambulance and 12% less than 20% of patients used an ambulance. Large variations in ambulance response times were reported both within and between countries. Most of the participating high-income countries (HIC) offered a service used by patients, but this was rarely the case for the low- and middle-income countries (LMIC). Time to admission was often much longer in LMIC, and there was less access to stroke training for EMS and primary care staff. Conclusions: Significant deficiencies in stroke prehospital care exist globally especially in LMIC. In all countries, there are opportunities to improve the quality of the service in ways that would likely result in improved outcomes after acute stroke. [ABSTRACT FROM AUTHOR]

Published
2023
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31. Stroke in Sierra Leone: Case fatality rate and functional outcome after stroke in Freetown.

Author

Youkee, Daniel, Deen, Gibrilla F, Baldeh, Mamadu, Conteh, Zainab F, Fox-Rushby, Julia, Gbessay, Musa, Johnson, Jotham, Langhorne, Peter, Leather, Andrew JM, Lisk, Durodami R, Marshall, Iain J, O'Hara, Jessica, Pessima, Sahr, Rudd, Anthony, Soley-Bori, Marina, Thompson, Melvina, Wafa, Hatem, Wang, Yanzhong, Watkins, Caroline L, and Williams, Christine E

Subjects
STROKE, DEATH rate, PROPORTIONAL hazards models
Abstract

Background: There is limited information on long-term outcomes after stroke in sub-Saharan Africa (SSA). Current estimates of case fatality rate (CFR) in SSA are based on small sample sizes with varying study design and report heterogeneous results. Aims: We report CFR and functional outcomes from a large, prospective, longitudinal cohort of stroke patients in Sierra Leone and describe factors associated with mortality and functional outcome. Methods: A prospective longitudinal stroke register was established at both adult tertiary government hospitals in Freetown, Sierra Leone. It recruited all patients ⩾ 18 years with stroke, using the World Health Organization definition, from May 2019 until October 2021. To reduce selection bias onto the register, all investigations were paid by the funder and outreach conducted to raise awareness of the study. Sociodemographic data, National Institute of Health Stroke Scale (NIHSS), and Barthel Index (BI) were collected on all patients on admission, at 7 days, 90 days, 1 year, and 2 years post stroke. Cox proportional hazards models were constructed to identify factors associated with all-cause mortality. A binomial logistic regression model reports odds ratio (OR) for functional independence at 1 year. Results: A total of 986 patients with stroke were included, of which 857 (87%) received neuroimaging. Follow-up rate was 82% at 1 year, missing item data were <1% for most variables. Stroke cases were equally split by sex and mean age was 58.9 (SD: 14.0) years. About 625 (63%) were ischemic, 206 (21%) primary intracerebral hemorrhage, 25 (3%) subarachnoid hemorrhage, and 130 (13%) were of undetermined stroke type. Median NIHSS was 16 (9–24). CFR at 30 days, 90 days, 1 year, and 2 years was 37%, 44%, 49%, and 53%, respectively. Factors associated with increased fatality at any timepoint were male sex (hazard ratio (HR): 1.28 (1.05–1.56)), previous stroke (HR: 1.34 (1.04–1.71)), atrial fibrillation (HR: 1.58(1.06–2.34)), subarachnoid hemorrhage (HR: 2.31 (1.40–3.81)), undetermined stroke type (HR: 3.18 (2.44–4.14)), and in-hospital complications (HR: 1.65 (1.36–1.98)). About 93% of patients were completely independent prior to their stroke, declining to 19% at 1 year after stroke. Functional improvement was most likely to occur between 7 and 90 days post stroke with 35% patients improving, and 13% improving between 90 days to 1 year. Increasing age (OR: 0.97 (0.95–0.99)), previous stroke (OR: 0.50 (0.26–0.98)), NIHSS (OR: 0.89 (0.86–0.91)), undetermined stroke type (OR: 0.18 (0.05–0.62)), and ⩾1 in-hospital complication (OR: 0.52 (0.34–0.80)) were associated with lower OR of functional independence at 1 year. Hypertension (OR: 1.98 (1.14–3.44)) and being the primary breadwinner of the household (OR: 1.59 (1.01–2.49)) were associated with functional independence at 1 year. Conclusion: Stroke affected younger people and resulted in high rates of fatality and functional impairment relative to global averages. Key clinical priorities for reducing fatality include preventing stroke-related complications through evidence-based stroke care, improved detection and management of atrial fibrillation, and increasing coverage of secondary prevention. Further research into care pathways and interventions to encourage care seeking for less severe strokes should be prioritized, including reducing the cost barrier for stroke investigations and care. [ABSTRACT FROM AUTHOR]

Published
2023
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