Khorasan stroke registry: analysis of 1392 stroke patients

The hospital-based stroke registry is useful for understanding diverse clinical characteristics of stroke related to geographical, racial, or environmental differences.

The Khorasan Stroke Registry was established for evaluation of incidence, clinical manifestations, risk factors, topography, and etiology of ischemic stroke in Southern Khorasan, Iran, during 2001 - 2005. Consecutive stroke patients underwent a standard battery of diagnostic investigations by a stroke neurologist. Topography and etiology of brain infarction was determined based on the Practical Iranian Criteria classification.

The incidence of ischemic stroke in Khorasan population is 43.17 cases per 100,000 people per year. During a 5-year period 1,392 ischemic stroke patients (738 females, 654 males) were evaluated in the Khorasan Stroke Registry. Atherosclerosis constituted 53.6% of etiologies followed by uncertain causes (19.9%), cardioembolism (11.8%), and miscellaneous etiologies (2.9%). Eleven point seven percent of our patients had both atherosclerosis and cardioembolic mechanisms. Rheumatic valvular disease was present in 44.8% of cardioembolic strokes and caused 4.31 preventable stroke cases per 100,000 Iranian population per year. Hypertension and history of ischemic cerebrovascular events were the most frequent risk factors, 53.1% and 22.3% respectively. In-hospital mortality of our ischemic stroke patients was 7.3%.

High frequency of atherosclerotic etiology in the Khorasan Stroke Registry is because of its classification criteria, which does not separate small vessel territory infarcts as a different etiologic subtype. Rheumatic valvular disease is an important cause of stroke in Khorasan population.