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dc.contributor.authorBalabanski, AH
dc.contributor.authorGoldsmith, K
dc.contributor.authorGiarola, B
dc.contributor.authorBuxton, D
dc.contributor.authorCastle, S
dc.contributor.authorMcBride, K
dc.contributor.authorBrady, S
dc.contributor.authorThrift, AG
dc.contributor.authorKatzenellenbogen, J
dc.contributor.authorBrown, A
dc.contributor.authorBurrow, J
dc.contributor.authorDonnan, GA
dc.contributor.authorKoblar, S
dc.contributor.authorKleinig, TJ
dc.date.accessioned2020-11-17T04:16:22Z
dc.date.available2020-11-17T04:16:22Z
dc.date.issued2020-10-08
dc.identifierpii: bmjopen-2020-039533
dc.identifier.citationBalabanski, A. H., Goldsmith, K., Giarola, B., Buxton, D., Castle, S., McBride, K., Brady, S., Thrift, A. G., Katzenellenbogen, J., Brown, A., Burrow, J., Donnan, G. A., Koblar, S. & Kleinig, T. J. (2020). Stroke incidence and subtypes in Aboriginal people in remote Australia: a healthcare network population-based study.. BMJ Open, 10 (10), pp.e039533-. https://doi.org/10.1136/bmjopen-2020-039533.
dc.identifier.issn2044-6055
dc.identifier.urihttp://hdl.handle.net/11343/251755
dc.description.abstractOBJECTIVES: We aimed to compare the incidence, subtypes and aetiology of stroke, and in-hospital death due to stroke, between Aboriginal and non-Aboriginal people in Central Australia, a remote region of Australia where a high proportion Aboriginal people reside (40% of the population). We hypothesised that the rates of stroke, particularly in younger adults, would be greater in the Aboriginal population, compared with the non-Aboriginal population; we aimed to elucidate causes for any identified disparities. DESIGN: A retrospective population-based study of patients hospitalised with stroke within a defined region from 1 January 2011 to 31 December 2014. SETTING: Alice Springs Hospital, the only neuroimaging-capable acute hospital in Central Australia, serving a network of 50 healthcare facilities covering 672 000 km2. PARTICIPANTS: 161 residents (63.4% Aboriginal) of the catchment area admitted to hospital with stroke. PRIMARY AND SECONDARY OUTCOME MEASURES: Rates of first-ever stroke, overall (all events) stroke and in-hospital death. RESULTS: Of 121 residents with first-ever stroke, 61% identified as Aboriginal. Median onset-age (54 years) was 17 years younger in Aboriginal patients (p<0.001), and age-standardised stroke incidence was threefold that of non-Aboriginal patients (153 vs 51 per 100 000, incidence rate ratio 3.0, 95% CI 2 to 4). The rate ratios for the overall rate of stroke (first-ever and recurrent) were similar. In Aboriginal patients aged <55 years, the incidence of ischaemic stroke was 14-fold greater (95% CI 4 to 45), and intracerebral haemorrhage 19-fold greater (95% CI 3 to 142) than in non-Aboriginal patients. Crude prevalence of diabetes mellitus (70.3% vs 34.0%, p<0.001) and hypercholesterolaemia (68.9% vs 51.1%, p=0.049) was greater, and age-standardised in-hospital deaths were fivefold greater (35 vs 7 per 100 000, 95% CI 2 to 11) in Aboriginal patients than in non-Aboriginal patients. CONCLUSIONS: Stroke incidence (both subtypes) and in-hospital deaths for remote Aboriginal Australians are dramatically greater than in non-Aboriginal people, especially in patients aged <55 years.
dc.languageeng
dc.publisherBMJ
dc.titleStroke incidence and subtypes in Aboriginal people in remote Australia: a healthcare network population-based study.
dc.typeJournal Article
dc.identifier.doi10.1136/bmjopen-2020-039533
melbourne.affiliation.departmentMedicine and Radiology
melbourne.source.titleBMJ Open
melbourne.source.volume10
melbourne.source.issue10
melbourne.source.pagese039533-
dc.rights.licenseCC BY-NC
melbourne.elementsid1477869
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC7545633
melbourne.contributor.authorDonnan, Geoffrey
dc.identifier.eissn2044-6055
melbourne.accessrightsOpen Access


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