Stroke outcome in clinical trial patients deriving from different countries

Background and Purpose—Stroke incidence and outcome vary widely within and across geographical locations. We examined whether differences in index stroke severity, stroke risk factors, mortality, and stroke outcome across geographical locations remain after adjusting for case mix. Methods—We anal...

Full description

Bibliographic Details
Main Authors:	Ali, Myzoon, Atula, Sari, Bath, Philip M.W., Grotta, James, Hacke, Werner, Lyden, Patrick D., Marler, John R., Sacco, Ralph L., Lees, Kennedy R.
Format:	Article
Published:	American Stroke Association 2008
Online Access:	https://eprints.nottingham.ac.uk/972/

_version_	1848790512875601920
author	Ali, Myzoon Atula, Sari Bath, Philip M.W. Grotta, James Hacke, Werner Lyden, Patrick D. Marler, John R. Sacco, Ralph L. Lees, Kennedy R.
author_facet	Ali, Myzoon Atula, Sari Bath, Philip M.W. Grotta, James Hacke, Werner Lyden, Patrick D. Marler, John R. Sacco, Ralph L. Lees, Kennedy R.
author_sort	Ali, Myzoon
building	Nottingham Research Data Repository
collection	Online Access
description	Background and Purpose—Stroke incidence and outcome vary widely within and across geographical locations. We examined whether differences in index stroke severity, stroke risk factors, mortality, and stroke outcome across geographical locations remain after adjusting for case mix. Methods—We analyzed 3284 patients from the Virtual International Stroke Trials Archive (VISTA). We used logistic regression to examine the incidence of mild index stroke, functional, and neurological outcomes after accounting for age, medical history, year of trial recruitment, and initial stroke severity in the functional and neurological outcome analyses. We examined mortality between geographical regions using a Cox proportional hazards model, accounting for age, initial stroke severity, medical history, and year of trial recruitment. Results—Patients enrolled in the USA and Canada had the most severe index strokes. Those recruited in Austria and Switzerland had the best functional and neurological outcomes at 90 days (P0.05), whereas those enrolled in Germany had the worst functional outcome at 90 days (P0.013). Patients enrolled in Austria, Switzerland, Belgium, Netherlands, Finland, Germany, Greece, Israel, Spain, and Portugal had a significantly better survival rate when compared with those enrolled in USA and Canada. Patients enrolled in trials after 1998 had more severe index strokes, with no significant difference in outcome compared with those enrolled before 1998. Conclusion—We identified regional variations in index stroke severity, outcome, and mortality for patients enrolled in ischemic stroke clinical trials over the past 13 years that were not fully explained by case mix. Index stroke severity was greater in patients enrolled after 1998, with no significant improvement in outcomes compared to those enrolled before 1998. (Stroke. 2009;40:000-000.)
first_indexed	2025-11-14T18:13:48Z
format	Article
id	nottingham-972
institution	University of Nottingham Malaysia Campus
institution_category	Local University
last_indexed	2025-11-14T18:13:48Z
publishDate	2008
publisher	American Stroke Association
recordtype	eprints
repository_type	Digital Repository
spelling	nottingham-9722020-05-04T16:27:20Z https://eprints.nottingham.ac.uk/972/ Stroke outcome in clinical trial patients deriving from different countries Ali, Myzoon Atula, Sari Bath, Philip M.W. Grotta, James Hacke, Werner Lyden, Patrick D. Marler, John R. Sacco, Ralph L. Lees, Kennedy R. Background and Purpose—Stroke incidence and outcome vary widely within and across geographical locations. We examined whether differences in index stroke severity, stroke risk factors, mortality, and stroke outcome across geographical locations remain after adjusting for case mix. Methods—We analyzed 3284 patients from the Virtual International Stroke Trials Archive (VISTA). We used logistic regression to examine the incidence of mild index stroke, functional, and neurological outcomes after accounting for age, medical history, year of trial recruitment, and initial stroke severity in the functional and neurological outcome analyses. We examined mortality between geographical regions using a Cox proportional hazards model, accounting for age, initial stroke severity, medical history, and year of trial recruitment. Results—Patients enrolled in the USA and Canada had the most severe index strokes. Those recruited in Austria and Switzerland had the best functional and neurological outcomes at 90 days (P0.05), whereas those enrolled in Germany had the worst functional outcome at 90 days (P0.013). Patients enrolled in Austria, Switzerland, Belgium, Netherlands, Finland, Germany, Greece, Israel, Spain, and Portugal had a significantly better survival rate when compared with those enrolled in USA and Canada. Patients enrolled in trials after 1998 had more severe index strokes, with no significant difference in outcome compared with those enrolled before 1998. Conclusion—We identified regional variations in index stroke severity, outcome, and mortality for patients enrolled in ischemic stroke clinical trials over the past 13 years that were not fully explained by case mix. Index stroke severity was greater in patients enrolled after 1998, with no significant improvement in outcomes compared to those enrolled before 1998. (Stroke. 2009;40:000-000.) American Stroke Association 2008-01-16 Article PeerReviewed Ali, Myzoon, Atula, Sari, Bath, Philip M.W., Grotta, James, Hacke, Werner, Lyden, Patrick D., Marler, John R., Sacco, Ralph L. and Lees, Kennedy R. (2008) Stroke outcome in clinical trial patients deriving from different countries. Stroke, 40 (1). pp. 35-40. ISSN 1524-4628 http://stroke.ahajournals.org/contents-by-date.0.shtml doi:10.1161/STROKEAHA.108.518035 doi:10.1161/STROKEAHA.108.518035
spellingShingle	Ali, Myzoon Atula, Sari Bath, Philip M.W. Grotta, James Hacke, Werner Lyden, Patrick D. Marler, John R. Sacco, Ralph L. Lees, Kennedy R. Stroke outcome in clinical trial patients deriving from different countries
title	Stroke outcome in clinical trial patients deriving from different countries
title_full	Stroke outcome in clinical trial patients deriving from different countries
title_fullStr	Stroke outcome in clinical trial patients deriving from different countries
title_full_unstemmed	Stroke outcome in clinical trial patients deriving from different countries
title_short	Stroke outcome in clinical trial patients deriving from different countries
title_sort	stroke outcome in clinical trial patients deriving from different countries
url	https://eprints.nottingham.ac.uk/972/ https://eprints.nottingham.ac.uk/972/ https://eprints.nottingham.ac.uk/972/

Stroke outcome in clinical trial patients deriving from different countries

Similar Items