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Characteristics, risk factors and mortality of stroke patients in Kyoto, Japan
  1. Kazuo Shigematsu1,
  2. Hiromi Nakano2,
  3. Yoshiyuki Watanabe3,
  4. Tatsuyuki Sekimoto4,
  5. Kouichiro Shimizu5,
  6. Akihiko Nishizawa6,
  7. Masahiro Makino7,
  8. Atsushi Okumura8,
  9. Kazuhiko Bando9,
  10. Yasushi Kitagawa10
  1. 1Department of Neurology, National Hospital Organization, Minami Kyoto Hospital, Kyoto, Japan
  2. 2Department of Neurosurgery, Kyoto Kidugawa Hospital, Kyoto, Japan
  3. 3Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
  4. 4Department of Neurosurgery, Kyoto Prefectural Yosanoumi Hospital, Kyoto, Japan
  5. 5Department of Neurosurgery, Kyoto Fushimi Shimizu Hospital, Kyoto, Japan
  6. 6Department of Internal Medicine, The Nishizawa Clinic, Kyoto, Japan
  7. 7Department of Neurology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
  8. 8Department of Neurosurgery, Jujyo Rehabilitation Hospital, Kyoto, Japan
  9. 9Department of Internal Medicine, The Bando Clinic, Kyoto, Japan
  10. 10Department of Internal Medicine, The Kitagawa Clinic, Kyoto, Japan
  1. Correspondence to Dr Kazuo Shigematsu; neuron.k07{at}gmail.com

Abstract

Objectives The aim of the study was to evaluate the characteristics, risk factors and outcome of recent stroke patients in Kyoto, Japan.

Design We analysed stroke patients in the registry with regard to their characteristics, risk factors and mortality. Cox proportional hazards regressions were used to calculate adjusted HRs for death.

Settings The Kyoto prefecture of Japan has established a registry to enrol new stroke patients in cooperation with the Kyoto Medical Association and its affiliated hospitals

Participants The registry now has data on 14 268 patients enrolled from 1 January 1999 to 31 December 2009. Of these, 12 774(89.5%) underwent CT, 9232 (64.7%) MRI, 2504 (17.5%) angiography and 342 (2.4%) scintigraphy. Excluding 480 (3.3%) unclassified patients, 13 788 (96.6%) patients formed the basis of further analyses which were divided into three subtypes: cerebral infarction (CI), cerebral haemorrhage (CH) and subarachnoid haemorrhage (SAH).

Results A total of 13 788 confirmed stroke patients in the study cohort comprised 9011 (86.3%) CI, 3549 (25.7%) CH and 1197 (8.7%) SAH cases. The mean age ±SD was 73.3±11.8, 69.1±13.6 and 62.7±13.5 in the CI, CH and SAH cases, respectively. Men were predominant in the CI and CH cases, whereas women were predominant in the SAH cases. The frequencies of risk factors were different among the subtypes. Mortality was worst in SAH, followed by CH, and least in CI. HRs for death adjusted for age, sex, histories of hypertension, arrhythmia, diabetes mellitus and hyperlipaemia and use of tobacco and/or alcohol showed a significant (p<0.001) difference among CI (as reference), CH (3.71; 3.11 to 4.43) and SAH (8.94; 7.21 to 11.11).

Conclusions The characteristics, risk factors and mortality were evaluated in a quantitative manner in a large Japanese study cohort to shed light on the present status of stroke medicine.

this is an open-access article distributed under the terms of the creative commons attribution non-commercial license, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. see: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2012-002181

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