0000000000067877

AUTHOR

Corine Aboa-eboulé

Psychosocial factors burden in workers with acute cerebro- or cardiovascular events: A multidisciplinary prospective pilot study

Introduction Psychosocial stress at work has been proposed as a risk factor for cerebro- and cardiovascular event (CVE) such as stroke or acute myocardial infarction (MI). However, data on psychosocial factors (PSF) profile in patients with CVE are scarce. In a multidisciplinary approach, we aimed to characterize PSF burden in patients with acute stroke or MI. Patients In a prospective pilot study, 45 patients aged  Results Among the 44 patients included, 77% had acute MI and 23% stroke. Mean age was 50 years, 77% were male, 43% were current smokers, 39% had hypertension, 41% hypercholesterolemia and 36% obesity. Education level was at 4,65 (secondary education), and most (41%) had low soci…

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How accurate is the reporting of stroke in hospital discharge data? A pilot validation study using a population-based stroke registry as control.

Population-based stroke registries can provide valid stroke incidence because they ensure exhaustiveness of case ascertainment. However, their results are difficult to extrapolate because they cover a small population. The French Hospital Discharge Database (FHDDB), which routinely collects administrative data, could be a useful tool for providing data on the nationwide burden of stroke. The aim of our pilot study was to assess the validity of stroke diagnosis reported in the FHDDB. All records of patients with a diagnosis of stroke between 2004 and 2008 were retrieved from the FHDDB of Dijon Teaching Hospital. The Dijon Stroke Registry was considered as the gold standard. The sensitivity, …

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Association between serum concentration of vitamin D and 1-year mortality in stroke patients.

<b><i>Background:</i></b> The prevalence of 25-hydroxyvitamin D [25(OH)D] deficiency is high in patients presenting with an acute stroke, and it may be associated with greater clinical severity and a poor early functional prognosis. However, no data about its impact on long-term prognosis is available. In this study, we aimed to assess the association between 25(OH)D levels and 1-year mortality in stroke patients. <b><i>Methods:</i></b> From February to December 2010, 382 Caucasian stroke patients admitted to the Department of Neurology of the University Hospital of Dijon, France, were enrolled prospectively. Demographics and clinical informat…

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Stroke care organization overcomes the deleterious ‘weekend effect’ on 1-month stroke mortality: a population-based study

Background and purpose Suffering a stroke during the weekend is associated with a poorer prognosis. The impact of implementing a dedicated stroke care network in Dijon, France, in 2003 on 30-day mortality in strokes/transient ischaemic attacks (TIA) occurring during weekends/bank holidays was evaluated. Methods All cases of stroke and TIA from 1985 to 2010 were identified from a population-based registry, using multiple overlapping sources of information. Demographics and clinical data were recorded. Cox regression models were used to evaluate associations between day of onset (weekdays versus weekends/bank holidays) and 30-day all-cause mortality. Data were stratified according to time per…

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Diagnostic Procedures in Ischaemic Stroke Patients with Dementia. A Population-Based Study

Background Dementia is a frequent condition in stroke patients. Aims To investigate the effect of dementia on access to diagnostic procedures in ischaemic stroke patients. Methods All cases of ischaemic stroke from 2006 to 2010 were identified from the population-based Stroke Registry of Dijon, France. Patients' characteristics were recorded, as was the use of brain computed tomography scans, brain magnetic resonance imaging, electrocardiogram, echocardiography, and Doppler ultrasonography of the cervical arteries. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Logistic regression models were used to evaluate the associations between d…

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014: Underuse of recommended secondary preventive therapies in current routine clinical practice

Aims Recommendations on the use of antithrombotic agents, antihypertensive drugs and statin for secondary prevention of coronary artery (CAD), ischemic cerebrovacular (CVD), and peripheral arterial (PAD) diseases are now well established. However, there may be a gap between clinical practice and evidence-based guidelines. We aimed to investigate the premorbid use of secondary prevention medications in patients with recurrent cardiovascular events. Methods and results We prospectively recorded all patients with CVD and CAD in Dijon, France from 2006 to 2010. Data about medical history and prior use of treatments were collected. Mutivariate analyses were performed to identify predictors of th…

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Poststroke Disposition and Associated Factors in a Population-Based Study

Background and Purpose— The organization of poststroke care will be a major challenge in coming years. We aimed to assess hospital disposition after stroke and its associated factors in clinical practice. Methods— All cases of stroke from 2006 to 2010 were identified from the population-based Stroke Registry of Dijon, France. Demographic features, risk factors, and prestroke treatments were recorded. Admission stroke severity was assessed using the National Institutes of Health Stroke Scale score. At discharge, we collected dementia, disability using the modified Rankin Scale, length of stay, and hospital disposition (home, rehabilitation, convalescent home, and nursing home). Multivariate…

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Secondary prevention in patients with vascular disease. A population based study on the underuse of recommended medications.

Objectives To investigate the premorbid use of secondary prevention medications in patients with recurrent vascular events. Design Prospective, observational, population based study. Setting The Dijon Stroke Registry and the registry of myocardial infarction of Dijon and Cote d9Or, France. Patients All patients with cerebral ischaemia (ischaemic stroke or transient ischaemic attacks) or coronary artery disease (CAD) and a history of vascular disease (cerebral ischaemia, CAD or peripheral arterial disease (PAD)) in Dijon, France from 2006 to 2010. Main outcome measures Data on medical history and prior use of treatments were collected. Mutivariate analyses were performed to identify predicto…

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One-year survival of demented stroke patients: data from the Dijon Stroke Registry, France (1985-2008)

Background and purpose:  Dementia is a frequent condition after stroke that may affect the prognosis of patients. Our aim was to determine whether post-stroke dementia was a predictor of 1-year case-fatality and to evaluate factors that could influence survival in demented stroke patients. Methods:  From 1985 to 2008, all first-ever strokes were recorded in the population-based stroke registry of Dijon, France (150 000 inhabitants). Dementia was diagnosed during the first month following stroke, according to DSM-III and DSM-IV criteria. Survival was evaluated at 1 year and multivariate analyses were performed using Cox proportional hazards to identify independent predictive factors. Results…

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Underuse of recommended secondary preventive therapies in current routine clinical practice

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Psychosocial factors burden in workers with acute cerebro- or cardiovascular events: A multidisciplinary prospective pilot study

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Une neuroprotection possible précédant l’infarctus cérébral : l’Accident Ischémique Transitoire (AIT)

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Time Trends in Hospital-Referred Stroke and Transient Ischemic Attack: Results of a 7-Year Nationwide Survey in France

<i>Background:</i> Nationwide evaluations of the burden of stroke are scarce. We aimed to evaluate trends in stroke and transient ischemic attack (TIA) hospitalization, in-hospital case fatality rates (CFRs) and mortality rates in France during 2000–2006. <i>Methods:</i> Hospitalizations for stroke and TIA were determined from National Hospital Discharge Diagnosis Records that used the International Classification of Disease, 10th revision, codes I60, I61, I63, I64, G45, G46. CFRs and mortality rates were estimated from the national death certificates database. <i>Results:</i> The total number of stays for stroke increased between 2000 and 2006 (88,371 vs…

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Smoking Status and Severity of Ischemic Stroke. A Population-Based Study

We aimed to investigate the impact of smoking status on clinical severity in patients with ischemic stroke event (IS). Patients were prospectively identified among residents of the city of Dijon, France (ca. 151,000 inhabitants), using a population-based registry, between 2006 and 2011. Demographic and clinical data were recorded. The initial clinical severity was quantified by the means of the National Institutes of Health Stroke Scale (NIHSS). Multivariable ordinal logistic regression was used to assess the effect of smoking status on severity. Among the 1,056 recorded patients with IS, data about smoking status were available for 973 (92.1%), of whom 658 (67.3%) were non-smokers, 187 (19…

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Prestroke antiplatelet therapy and early prognosis in stroke patients: the Dijon Stroke Registry

Background and purpose Previous antiplatelet therapy (APT) in cardiovascular prevention is common in patients with first-ever stroke. We aimed to evaluate the prognostic value of APT on early outcome in stroke patients. Methods All first-ever strokes from 1985 to 2011 were identified from the population-based Stroke Registry of Dijon, France. Demographic features, risk factors, prestroke treatments and clinical information were recorded. Multivariate analyses were performed to evaluate the associations between pre-admission APT and both severe handicap at discharge, and mortality at 1 month and 1 year. Results Among the 4275 patients, 870 (20.4%) were previously treated with APT. Severe han…

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The Impact of World and European Football Cups on Stroke in the Population of Dijon, France: A Longitudinal Study from 1986 to 2006

Background: Acute stress may trigger vascular events. We aimed to investigate whether important football competitions involving the French football team increased the occurrence of stroke. Methods: We retrospectively retrieved data of fatal and nonfatal stroke during 4 World Football Cups (1986, 1998, 2002, and 2006) and 4 European Championships (1992, 1996, 2000, and 2004), based on data from the population-based Stroke Registry of Dijon, France. One period of exposure was analyzed: the period of competition extended to 15 days before and after the competitions. The number of strokes was compared between exposed and unexposed corresponding periods of preceding and following years using Poi…

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Sensibilité et valeur prédictive positive du Programme de médicalisation des systèmes d’information (PMSI) pour le recueil des données d’accidents vasculaires cérébraux : étude de validation préliminaire avec le Registre dijonnais des accidents vasculaires cérébraux comme gold standard

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