Risk factors, causes, and outcome in stroke types in Mexico. The RENAMEVASC Study [Factores de riesgo, causas y pronóstico de los tipos de enfermedad vascular cerebral en México: Estudio RENAMEVASC]
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Background and objectives: In spite that stroke has become a public health problem in Mexico, there are few information regarding several issues on strtoke epidemiology. The main objectives of the present study were to determine, by means of a multicentric stroke registry, the prevalence of the stroke types, their vascular risk factors and the short-term outcome. Patients and methods: Prospective observational study of consecutive cases of stroke recruited in 25 hospitals (in 14 states of Mexico). The following information was obtained: demographic data, vascular risk factors, mechanisms and causes of stroke types, and clinical outcome. Descriptive statistical analysis (frequencies and medians) using χ2 y Kruskal-Wallis for contrasting differences among stroke types. Resulted: We studied 2000 patients: women 55%25, men 45%25 (p < 0.001) with median age of 64 years (IQR 49-75). Stroke types: tranient ischemic attack 5%25, cerebral infarction 52%25, intracerebral hemorrhage (ICH) 28%25, subarachnoid hemorrhage (SAH) 12.0%25, and cerebral venous thrombosis (CVT) 3.0%25. Causes of cerebral infarct: atherosclerosis 14.7%25, cardioembolism 24.7%25, small vessel disease 19.4%25, other 4.6%25, undetermined 36.6%25. Causes of ICH: hypertensive 67%25, vascular malformations 7.8%25, amiloid angiopaty 4%25, hematologic disorders 4%25, other 8%25, undetermined 10%25. Causes of SAH: aneurysm 86%25, perimesencephalic 6%25, other 2%25, undetermined 6%25. Causes CVT: puerperium/ pregnancy 47%25, contraceptives agents 13%25, other 17%25, undetermined 23%25. Short-term clinical outcome (30 days): Excellent recovery (Rankin 0/1) 41%25; mild and moderate disability (R 2/3) 18%25; severe disability (R 4/ 5) 20%25 and death 21%25. Conclusions: Main mechanisms and causes of stroke in Mexico are described, revealing a higher frequency of ICH and CVT in Mexico than occidental countries. More than half of patients had poor outcome because they died or had some grade of disability.
