Occurrence, presentation, costs and three-month outcomes of stroke in Viet Nam

摘要: Background - Stroke is the third most common cause of death in world and projected to be second leading by year 2020. Although rates stroke mortality have decreased high income countries (HICs) recent decades, burden may increasing low middle (LMICs) but information scarce. To address this critical lack data for Viet Nam, five studies occurrence, costs treatment short-term outcomes were conducted. Methods - The first study involved surveillance 5,017 admissions patients over 12 months at a tertiary public teaching hospital Ho Chi Minh City. obtain on three months, 450 consecutive with first-ever followed-up. The remaining four thesis present findings from follow-up study. Results - Principal that median age was 65.0 years, ischaemic dominant type, majority events, signs symptoms similar Nam as elsewhere. Around one-half had scores modified Rankin Scale (mRS) corresponding severe disability (mRS=4/5). estimated incidence hospital-admitted 105.6 per 100,000 person-years, confirmed case-fatality 28 days 12.2%. Case-fatality functional 3 after assessed study. With minimal loss follow-up, 10.4% one-third survivors Over improved status one-quarter worsened, male having greater improvement. In study, 437 cohort used estimate treatment. Average total admission USD 963 comprising 560 direct medical cost, 171 non-medical 240 indirect costs. Health insurance halved out-of-pocket Severity stroke, length stay household wealth major predictors cost. The reliability validity Duke Profile (DHP) assessing Related Quality Life (HRQoL) examined fourth 108 94 caregivers patients. They completed DHP questionnaire comparison instrument, EQ-5D. Each re-administered 1 week. Intra-class correlations ranged 0.60 0.86 (patient test-retest) 0.55 0.98 (patient-proxy agreement). Correlations between EQ-5D dimensions strongest constructs (r=0.53–0.66). The HRQoL 373 fifth Their average overall score (58.7) utility (0.67) lower than those comparable general population samples. Female sex, age, SES, time poor poorer HRQoL. Conclusions implications - Young onset relative HICs, proportion moderate-to-severe disability, confers Nam. clinical presentation suggests campaigns HICs raise awareness early could adopted factors associated occurrence prompt application strategies prevention management are effective HICs. Despite relatively short stay, amounted 2 times monthly insured non-insured patients, respectively. Broader health coverage Vietnamese would help bridge gap. overload unit signals need more units established other hospitals HCMC surrounds. Measurements DHP, which has moderate use demonstrated reduces reported psychological well-being survivors, particularly female