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Title: Prospective analysis of stroke recognition, stroke risk factors, thrombolysis rates and outcomes in Indigenous Australians from a large rural referral hospital.
Austin Authors: Santos, Angela Dos;Mohr, Katherine;Jude, Martin;Simon, Neil G;Parsons, Mark;Eades, Sandra;Burchill, Luke;Davis, Stephen;Donnan, Geoffrey A ;Churliov, Leonid;Delcourt, Candice
Affiliation: Medicine (University of Melbourne)
The University of New South Wales, Rural Clinical School, Wagga Wagga, NSW, Australia..
The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia..
Northern Clinical School, The University of Sydney, North Sydney, NSW, Australia..
Melbourne Brain Centre at Royal Melbourne Hospital, Parkville, VIC, Australia..
The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia..
The Wagga Wagga Rural Referral Hospital, Wagga Wagga, NSW, Australia..
Royal Prince Alfred Hospital, The University of Sydney, Sydney, NSW, Australia..
Issue Date: Mar-2022
Publication information: Internal medicine journal 2022; 52(3): 468-473
Abstract: Cardiovascular disease is the most common cause of death and disability in indigenous communities but limited prospective data exist about stroke. To estimate the difference in stroke recognition, risk factors, treatment rates and outcomes between indigenous and non-indigenous peoples admitted to the Wagga Wagga Rural Referral Hospital (WWRRH) over a 5-year period with a suspected acute stroke. All suspected strokes presenting to the 33 peripheral hospitals within the Murrumbidgee Local Health District (MLHD) were transferred to the WWRRH and prospectively assessed over a 5-year period from 1 January 2012 to 31 December 2017. Actions at stroke onset, risks factors, stroke type, treatment and outcomes were analysed. A total of 1843 patients were included. Of these, 45 (2.5%) patients were indigenous. Only 26.6% of indigenous and 34% of non-indigenous patients knew of the face, arm, speech, time (FAST) acronym. Indigenous patients were younger (mean age 62.0 years vs 74.4 years) and more likely to have diabetes (risk difference (RD) 22.3% (95% CI: 3%, 41.7%)), dyslipidaemia (RD 19.4% (95% CI: 21.%, 36.7%)), and be ever smokers (RD 24.9% (95% CI: 9.5%, 40.3%)). Stroke types were similar except lacunar infarcts were more common (19.2% vs 8.4%). Treatment rates and outcomes were similar between the two groups. Indigenous Australians with stroke are a decade younger and have a higher prevalence of important, modifiable stroke-risk factors. Delayed presentation to hospital is more common, due in part to stroke symptoms being underrecognised. When admitted to a specialised stroke unit, treatment rates and outcomes are comparable.
DOI: 10.1111/imj.15080
ORCID: 0000-0003-4301-9396
Journal: Internal medicine journal
PubMed URL: 33012066
PubMed URL:
Type: Journal Article
Subjects: Indigenous Australians
risk factors
Appears in Collections:Journal articles

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