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[International Stroke Trial Switzerland: some epidemiologic data]
H P Mattle1, E Eicher Vella, C Bassetti
1Neurologische Universitätsklinik, Inselspital, Bern. heinrich.mattle@insel.ch
Schweizerische Medizinische Wochenschrift
|January 19, 2000
Summary
Comparing Swiss patients in the International Stroke Trial (IST) with international cohorts revealed differences in age and stroke type. Despite earlier treatment, Swiss patients had higher rates of death or dependency, primarily due to age and stroke severity.
Area of Science:
- Neurology
- Clinical Trials
- Public Health
Background:
- Randomised controlled trials (RCTs) are crucial for evaluating treatment efficacy and patient outcomes.
- International Stroke Trial (IST) data offers insights into stroke patient characteristics and outcomes across different regions.
Purpose of the Study:
- To compare baseline characteristics and 6-month outcomes of Swiss patients with those from other countries in the International Stroke Trial (IST).
- To identify factors influencing outcome differences between Swiss and international stroke patient cohorts.
Main Methods:
- Analysis of data from 1631 Swiss patients and 17,804 international patients randomized in the IST.
- Comparison of baseline demographics, stroke types, treatment timing, and 6-month mortality or dependency rates.
Main Results:
- Swiss patients were older, more likely to have total anterior circulation infarcts, less likely to have lacunar strokes, and received earlier treatment compared to international cohorts.
- Swiss patients experienced higher rates of death or dependency at 6 months (66.9% vs. 62.2%).
- Age and stroke severity at baseline largely explained the observed differences in outcomes.
Conclusions:
- Between-country comparisons of stroke outcomes are complex and influenced by patient demographics and stroke characteristics.
- International multicenter trials must employ robust randomization methods (e.g., stratification, minimization) to ensure balanced prognostic factors within each country, preventing confounding of treatment effects.