Program for the epidemiological evaluation of stroke in Tandil, Argentina (PREVISTA) study: rationale and design

The availability of population-based epidemiological data on the incident risk of stroke is very scarce in Argentina and other Latin American countries. in response to the priorities established by the World Health Organization and the United Nations, PREVISTA was envisaged as a population-based program to determine the risk of first-ever and recurrent stroke and transient ischemic attack incidence and mortality in Tandil, Buenos Aires, Argentina.The study will be conducted according to Standardized Tools for Stroke Surveillance (STEPS Stroke) methodology and will enroll all new (incident) and recurrent consecutive cases of stroke and transient ischemic attack in the City of Tandil between May 1st, 2013 and April 30, 2015. the study will include patients with ischemic stroke, non-traumatic primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack. To ensure the inclusion of every cerebrovascular event during an observation period of two years, we will instrument an 'intensive screening program', consisting of a comprehensive daily tracking of every potential event of stroke or transient ischemic attack using multiple overlapping sources. Mortality would be determined during follow-up for every enrolled patient. Also, fatal community events would be screened daily through revision of death certificates at funeral homes and local offices of vital statistics. All causes of death will be adjudicated by an ad-hoc committee.The close population of Tandil is representative of a large proportion of Latin-American countries with low- and middle-income economies. the findings and conclusions of PREVISTA may provide data that could support future health policy decision-making in the region.Heart and stroke Foundation of CanadaINECO Fdn, Vasc Res Inst, Buenos Aires, DF, ArgentinaUniv Western Ontario, London Hlth Sci Ctr, Dept Clin Neurol Sci, London, ON N6A 5A5, CanadaHosp Ramon Santamarina, Tandil, Buenos Aires, ArgentinaNueva Clin Chacabuco, Tandil, Buenos Aires, ArgentinaSanatorio Tandil, Tandil, Buenos Aires, ArgentinaAUT Univ, Sch Rehabil & Occupat Studies, Natl Inst Stroke & Appl Neurosci, Auckland, Northcote, New ZealandUniversidade Federal de São Paulo, Paulista Sch Med, São Paulo, BrazilDuke Clin Res Inst, Durham, NC USABCRI, São Paulo, BrazilMayo Clin, Neurosci Intens Care Unit, Rochester, MN USAUniv Toronto, St Michaels Hosp, Li Ka Shing Knowledge Inst, Stroke Outcomes Res Ctr,Dept Med, Toronto, ON, CanadaUniv Toronto, St Michaels Hosp, Li Ka Shing Knowledge Inst, Stroke Outcomes Res Ctr,Dept Hlth Policy Manageme, Toronto, ON, CanadaUniv Toronto, St Michaels Hosp, ICES, Toronto, ON, CanadaCopenhagen Univ Hosp, Dept Neurol, Herlev, DenmarkCirculo Med Tandil, Buenos Aires, DF, ArgentinaResonancia Ctr, Tandil, ArgentinaUniversidade Federal de São Paulo, Paulista Sch Med, São Paulo, BrazilWeb of Scienc

First-ever stroke and transient ischemic attack incidence and 30-day case-fatality rates in a population-based study in Argentina

Background and Purpose - Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina. Methods - We prospectively identified all first-ever stroke and TIA cases from overlapping sources between January 5, 2013, and April 30, 2015, in Tandil, Argentina. We calculated crude and standardized incidence rates. We estimated 30-day case-fatality rates. Results - We identified 334 first-ever strokes and 108 TIAs. Age-standardized incidence rate per 100 000 for Segi's World population was 76.5 (95% confidence interval [CI], 67.8-85.9) for first-ever stroke and 25.1 (95% CI, 20.2-30.7) for first-ever TIA, 56.1 (95% CI, 48.8-64.2) for ischemic stroke, 13.5 (95% CI, 9.9-17.9) for intracerebral hemorrhage, and 4.9 (95% CI, 2.7-8.1) for subarachnoid hemorrhage. Stroke incidence was slightly higher for men (87.8; 95% CI, 74.6-102.6) than for women (73.2; 95% CI, 61.7-86.1) when standardized for the Argentinean population. Thirty-day case-fatality rate was 14.7% (95% CI, 10.8-19.5) for ischemic stroke, 24.1% (95% CI, 14.2-36.6) for intracerebral hemorrhage, and 1.9% (95% CI, 0.4-5.8) for TIA. Conclusions - This study provides the first prospective population-based stroke and TIA incidence and case-fatality estimate in Argentina. First-ever stroke incidence was lower than that reported in previous Latin-American studies, but first-ever TIA incidence was higher. Thirty-day case-fatality rates were similar to those of other population-based Latin-American studies.Fil: Bahit, M. Cecilia. Ineco Neurociencias Oroño; ArgentinaFil: Coppola, Mariano L.. Hospital Municipal Sofía Santamarina; ArgentinaFil: Riccio, Patricia M.. Western University; CanadáFil: Cipriano, Lauren E.. Ivey Business School; CanadáFil: Roth, Gregory A.. University Of Washington; Estados UnidosFil: Lopes, Renato D.. Duke University Medical Center; Estados UnidosFil: Feigin, Valery L.. Auckland University Of Technology; Nueva ZelandaFil: Borrego Guerrero, Brenda. Sanatorio Tandil; ArgentinaFil: De Martino, Maximiliano. Hospital Municipal Sofía Santamarina; ArgentinaFil: Diaz, Alberto Alejandro. Hospital Municipal Sofía Santamarina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ferrante, Daniel. Ministerio de Salud de la Nación; ArgentinaFil: Funaro, Fernando. Nueva Clínica Chacabuco; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lavados, Pablo. Universidad del Desarrollo; Chile. Universidad de Chile; ChileFil: Lewin, M. Laura. Hospital Municipal Sofía Santamarina; ArgentinaFil: López, Daniel H.. Círculo Médico de Tandil; ArgentinaFil: Macarrone, Patricia. Nueva Clínica Chacabuco; ArgentinaFil: Marciello, Rafael. Hospital Municipal Sofía Santamarina; ArgentinaFil: Marino, Diego. Sanatorio Tandil; ArgentinaFil: Martens, Cecilia. Hospital Municipal Sofía Santamarina; ArgentinaFil: Martínez, Paula. Nueva Clínica Chacabuco; ArgentinaFil: Odriozola, Guillermo. Hospital Municipal Sofía Santamarina; ArgentinaFil: Rabinstein, Alejandro A.. Mayo Clinic; Estados UnidosFil: Saposnik, Gustavo. Saint Michael's Hospital University Of Toronto; CanadáFil: Silva, Damián. Hospital Municipal Sofía Santamarina; ArgentinaFil: Suasnabar, Ramón. Nueva Clínica Chacabuco; ArgentinaFil: Truelsen, Thomas. Rigshospitalet; DinamarcaFil: Uzcudun, Araceli. Hospital Municipal Sofía Santamarina; ArgentinaFil: Viviani, Carlos A.. Círculo Médico de Tandil; ArgentinaFil: Sposato, Luciano A.. Western University; Canad