Kevin Agostino NOSM Medical Student Dr. Saleem Malik Associate Professor NOSM.
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Transcript of Kevin Agostino NOSM Medical Student Dr. Saleem Malik Associate Professor NOSM.
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Kevin Agostino NOSM Medical Student
Dr. Saleem Malik Associate Professor NOSM
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What is a Stroke (CVA)?
Sudden loss of blood circulation to an area of the brain
May/may not result in a loss of neurologic function
Classified into:HemorrhagicIschemic
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Classification of Stroke (CVA)
HemorrhagicIntracerebral HemorrhageSubarachnoid Hemorrhage
IschemicTransient Ischemic AttackThrombotic StrokeEmbolic StrokeSystemic Hypoperfusion
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Traditional Risk Factors
Diabetes
Hyperlipidemia
Hypertension
Atrial Fibrillation
Smoking
Genetics
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Rationale
Few studies exist
Risks associated with cerebrovascular disease higher in the Aboriginal population
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Goals The goals of this study were to:
Assess the demographics
Understand roles of underlying conditions and risk factors
Explore presentation of cerebrovascular disease
Assess mortality rate
Compared to non-Aboriginal population
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Methods
Three Northern Ontario Stroke hospitals
Registry of the Canadian Stroke Network (RCSN) was analyzed to determine:
DemographicsRisk factors Presentation Roles of underlying conditionsRankin score upon discharge Seven-day mortality
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Subjects
2,721 stroke subjects from Northern Ontario inputted into the RCSN database
The community consultation process was undertaken
Three Aboriginal liaisons
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Results
Ethnicity of Patient Population with Stroke:
70% Aboriginal1% Asian2% Caribbean19% Caucasian1% East Indian2% Hispanic1% Pacific Islander4% other
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Results Mean age of stroke:
Aboriginal males: 62.45 yrs Males in other population: 70.31 yrs
Aboriginal females: 57.07 yrsFemales in other population: 73.75 yrs
Mean age of stroke in both males and females:
Aboriginal population: 60.31 yrs Other population: 71.92 yrs
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Results Diabetes:
Aboriginal population: 56.3%Other population: 24.9%
Valvular Heart Disease:Other population: 5.2% Aboriginal population: 0%
Atrial Fibrillation or Flutter:Other population: 14.2% Aboriginal population: 6.8%
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Results Hypertension:
Aboriginal population: 65.0% Other population: 61.3%
Hyperlipidemia:Aboriginal population: 33.0% Other population: 27.3%
Chronic congestive heart failure/pulmonary edema:Aboriginal population: 6.8% Other population: 5.8%
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Results Deep vein thrombosis/pulmonary embolus:
Other population: 2.3% Aboriginal population: 0%
Coronary artery disease/angina pectoris:Other population: 20.6% Aboriginal population: 19.4%
Previous stroke:Other population: 20.6% Aboriginal population: 18.4%
Peripheral vascular disease, carotid endarterectomy or stenting, and previous TIA: little clinical significance
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Results Current smokers:
Aboriginal population: 31.1% Other population: 18.4%
Lifelong non-smokers:Aboriginal population: 53.4% Other population: 62.8%
The Aboriginal population reported alcohol use:more rarely (68.9% vs 58.0%)< 2 drinks/day (5.8% vs 9.9%)2+ drinks/day (8.7% vs 5.7%)
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Results Ischemic stroke:
Aboriginal population: 64.1% Other population: 60.4%
Hemorrhagic stroke:Aboriginal population: 11.6% Other population: 9.5%
TIA:Aboriginal population: 22.3% Other population: 29.8%
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Conclusions
Mean age of stroke for both Aboriginal males and females combined was lower
Mean age of stroke in Aboriginal females was significantly lower
Most prevalent risk factors:SmokingBinge Drinking
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Conclusions
Significant contributors to stroke:DiabetesHypertensionHyperlipidemia
Most prevalent stroke type:Ischemic Stroke
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Acknowledgements
The Registry of the Canadian Stroke Network (RCSN)
Northwestern Ontario Regional Stroke Network
Dr. David Howse, Neurology, Medical Director of the Regional Stroke Program
Cheryl Bain, Coordinator RCSN Diane Hiscox, Coordinator of the
Regional Stroke Program