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Ischemic strokes are more severe in Poland than in the United States
D Ryglewicz1, D B Hier, M Wiszniewska
1Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
Insights
Stroke case fatality rates were significantly higher in Poland (23.9%) compared to the United States (7.5%). Polish stroke patients also presented with more comorbidities and greater stroke severity, impacting outcomes.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Stroke is a leading cause of death and disability worldwide.
- International comparisons of stroke outcomes are crucial for identifying disparities in care and patient populations.
Purpose of the Study:
- To compare prospective case fatality rates for stroke between Poland and the United States.
- To identify differences in patient comorbidities and stroke severity between the two countries.
Main Methods:
- Prospective ascertainment of stroke case fatality rates.
- Data collected from two regional hospitals in Poland and 36 teaching hospitals in the US University Hospital Consortium.
- Comparison of demographic data, comorbidities, and stroke severity indicators.
Main Results:
- Stroke case fatality rates were substantially higher in Poland (23.9%) than in the United States (7.5%).
- Polish patients exhibited higher frequencies of angina, atrial fibrillation, and congestive heart failure.
- Greater stroke severity was observed in Poland, indicated by higher rates of hemiplegia, disordered consciousness, dysphagia, and aphasia.
Conclusions:
- Significant disparities exist in stroke outcomes between Poland and the United States.
- Higher rates of comorbidities and stroke severity in Poland may contribute to increased case fatality.
- Further research is warranted to explore the underlying reasons for these outcome differences.
Abstract:
Case fatality rates for stroke were ascertained prospectively in two regional catchment hospitals in Poland and 36 teaching hospitals in the US University Hospital Consortium. Case fatality rates in Poland (23.9%) were higher than in the United States (7.5%). Angina, atrial fibrillation, and congestive heart failure were more frequent in Polish stroke patients (40%, 26%, and 25%, respectively) than in US patients (17%, 12%, and 10%). Stroke severity as indicated by higher frequencies of hemiplegia, disordered consciousness, dysphagia, and aphasia was greater in Poland (19%, 39%, 28%, and 42%, respectively) than the United States (11%, 13%, 14%, and 26%).