None listed
Conditions
Brief summary
The last Adelaide Stroke Incidence Study (ASCEND) was carried out for 12 months between 2009 and 2010, sampling the western suburbs of Adelaide. We are 10 years on, and significant changes to the delivery model of stroke care in South Australia has occurred. Newer acute therapies and primary prevention methods, with shifting demographics make a repeat study necessary. A repeat population based study in South Australia (SA) will allow: 1. Identification of current Stroke incidence, outcome, recurrence rates and aetiology in SA. 2. Comparison to other Australian and International incidence studies – Are we still providing good quality care? 3. Comparison to initial ASCEND population – Are our primary prevention strategies well targeted? Is stroke incidence and aetiology evolving? Are risk profiles changing and are we managing risk better? 4. Evaluating future burden of stroke in SA for better directed resource allocation. 5. Identifying gaps in our current model of hyperacute stroke care provision. Are we missing out on revascularisation opportunities of Large Vessel occlusion strokes? 6. Understanding of how evolving demographics is modifying stroke incidence and risk profiles. 7. Comparison of Coded stroke aetiology to Trial of ORG 10172 in Acute Stroke Treatment (TOAST); Atherosclerosis, Small vessel disease, Cardioembolism, Other, Dissection (ASCOD) criteria and causative classification system (CCS) criteria. 8. Investigating the embolic stroke of undetermined source population for rates of symptomatic non-stenotic carotid disease (SyNC) to see if this may be a potential under-reported aetiology that warrants a different treatment paradigm. Expressed in the null, our main hypothesis is that in South Australia (SA), the age adjusted incidence of stroke will be similar to that reported 10 years ago in a similar population. In summary, a repeat Adelaide stroke incidence study, will allow an accurate contemporary classification of stroke incidence, risk profiles, subtypes and outcomes assisting in judicious delivery of primary prevention, hyperacute, subacute and rehabilitation stroke services in SA and nationally
Interventions
Patients who present with new onset ischemic stroke, transient ischemic attack (TIA), intracerebral haemorrhage or non-traumatic subarachnoid haemorrhage will be recruited prospectively and followed up at 3 months, and 12 months.
At baseline:
• Demographic Data
• Stroke history: onset date, symptoms, presentation;
• Past Medical History and known risk factors, prior medications, adherence to primary prevention;
• General health and wellbeing prior to the stroke including pre-stroke mRS
• Diag
Patients who present with new onset ischemic stroke, transient ischemic attack (TIA), intracerebral haemorrhage or non-traumatic subarachnoid haemorrhage will be recruited prospectively and followed up at 3 months, and 12 months. At baseline: • Demographic Data • Stroke history: onset date, symptoms, presentation; • Past Medical History and known risk factors, prior medications, adherence to primary prevention; • General health and wellbeing prior to the stroke including pre-stroke mRS • Diagnostic tests and their results: radiology; bloods and cardiology results; • Treatments: emergency treatment and management of symptoms; • Availability of allied health treatments: physiotherapy/occupational therapy/dietetics; and • Discharge plan: referral to rehabilitation/care packages/accommodation requirements/ medications At 3 months and 12 months: • Blood pressure (3 months only) • Quality of life (Euro-QOL 5D) • Stroke impact and recovery (modified rankin scale) • Control of secondary risk factors • Adherence to medication • Cognitive impairment (three months only) (utilising the Montreal Cognitive Assessment, MOCA) • Financial impact to patient and community (time spent in hospital, change in employment status, time spent at home) • Health service utilisation.
Sponsors
Royal Adelaide Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients presenting with acute neurological symptoms of potential cerebrovascular aetiology within pre-defined postcodes, over a defined 24 month period. 2. Age greater than or equal to 18 years
Exclusion criteria
1. Age < 18 years 2. Brain masses/tumours/structural lesions 3. Subdural and extradural hemorrhage 4. Traumatic SAH 5. Other mimics including post seizure palsies, hypoglycemia, metabolic derangement, functional neurological disorders, etc
Outcome results
None listed