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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
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Stroke Epidemiology in an Australian Rural Cohort (SEARCH)
Jonathan Newbury1, Tim Kleinig1,2,3, James Leyden3
11 The University of Adelaide, Adelaide, Australia.
Summary
This study reveals declining stroke incidence in rural Australia, similar to urban trends. Inadequate anticoagulation for atrial arrhythmias remains a key preventable cause of ischemic stroke.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke incidence in Australia and New Zealand has declined since 1990.
- Previous studies focused solely on urban populations, leaving rural trends under-researched.
Purpose of the Study:
- To determine stroke incidence in a rural Australasian population.
- To compare rural stroke rates with existing urban data.
- To identify risk factors and outcomes in rural stroke patients.
Main Methods:
- Complete ascertainment of stroke cases from five rural centers over two years.
- Adherence to the World Health Organization (WHO) standard definition of stroke.
- Classification of ischemic stroke using the TOAST criteria, with 12 months of follow-up.
Main Results:
- A crude stroke attack rate of 113 per 100,000 per year was observed.
- Standardized incidence of first-ever strokes was 50 per 100,000.
- Ischemic strokes constituted 77% of cases, with 44% being cardioembolic, often linked to untreated atrial arrhythmias.
Conclusions:
- The study confirms a downward trend in stroke incidence in Australia, extending to rural areas.
- Inadequate anticoagulation for atrial fibrillation is a significant, preventable contributor to ischemic stroke.
- This research highlights the need for improved stroke prevention strategies in rural populations.
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