The Third China National Stroke Registry (CNSR-Ⅲ) for patients with acute ischaemic stroke or transient ischaemic attack: design, rationale and baseline patient characteristics

Background and purpose Stroke is the leading cause of mortality and disability in China.Precise aetiological classification,imaging and biological markers may predict the prognosis of stroke.The Third China National Stroke Registry(CNSR-Ⅲ),a nationwide registry of ischaemic stroke or transient ischaemic attack(TIA)in China based on aetiology,imaging and biology markers,will be considered to clarify the pathogenesis and prognostic factors of ischaemic stroke.Methods Between August 2015 and March 2018,the CNSR-Ⅲrecruited consecutive patients with ischaemic stroke or TIA from 201 hospitals that cover 22 provinces and four municipalities in China.Clinical data were collected prospectively using an electronic data capture system by face-to-face interviews.Patients were followed for clinical outcomes at 3 months,6 months and 1-5 year annually.Brain imaging,including brain MRI and CT,were completed at baseline.Blood samples were collected and biomarkers were tested at baseline.Results A total of 15166 stroke patients were enrolled,among which 31.7%patients were women with the average age of 62.2±11.3 years.Ischaemic stroke was predominant(93.3%,n=14146)and 1020(6.7%)TIAs were enrolled.Conclusions CNSR-Ⅲis a large scale nationwide registry in China.Data from this prospective registry may provide opportunity to evaluate imaging and biomarker prognostic determinants of stroke.

Gastrointestinal bleeding during acute ischaemic stroke hospitalisation increases the risk of stroke recurrence

Objective Gastrointestinal(GI)bleeding in patients who had a stroke is strongly associated with a higher risk of death and loss of independence.However,it is unknown whether GI bleeding increases risk for recurrence of stroke.In this study,we assess the potential relationship between GI bleeding and stroke recurrence in patients within 12 months of an acute ischaemic stroke(AIS),using the China National Stroke Registry(CNSR).Methods This study included 22216 patients who had an ischaemic stroke included in the CNSR from 2007 to 2008.We analysed baseline patient characteristics,GI bleeding and outcomes of patients who had an AIS,specifically stroke recurrence at 3,6 and 12 months.We used multivariable logistic regression to evaluate a possible association between GI bleeding and stroke recurrence.results Of the 12415 patients included in our study,12.3%,15.5%and 17.7%had a stroke recurrence at 3,6 and 12 months,respectively.GI bleeding was an independent stroke recurrence risk factor in patients after ischaemic stroke at 3 months(adjusted OR 1.481,95%CI 1.118 to 1.962),6 months(adjusted OR 1.448,95%CI 1.106 to 1.896)and 12 months(adjusted OR 1.350;95%CI 1.034 to 1.763).Conclusion GI bleeding was associated with the increased risk of stroke recurrence after an AIS.

In- hospital complications affect short- term and long- term mortality in ICH: a prospective cohort study

Background Medical complications strongly affected the mortality of patients with stroke.However,only limited research has studied the effect of in-hospital medical complications on the mortality of patients with spontaneous intracerebral haemorrhage(ICH)globally.Using the China National Stroke Registry,the effect was prospectively and systematically investigated in patients with spontaneous ICH during their hospitalisation,at 3,6 and 12 months after disease onset.Methods This study collected data on patients over 18 years old with spontaneous ICH from 132 Chinese clinical centres across 32 provinces and four municipalities(Hong Kong included),from September 2007 to August 2008.Data on patient complications,death and other information were acquired through paper-based registry forms.Using multivariable logistic regression,the association of medical complications with stroke outcomes was evaluated.Results Of 3255 patients with spontaneous ICH,878(26.97%)had in-hospital medical complications.In-hospital medical complications were independent risk factors for death during the hospitalisation(adjusted OR 4.41,95% CI 3.18 to 6.12),at 3 months(adjusted OR 2.18,95% CI 1.70 to 2.80),6 months(adjusted OR 1.84,95% CI 1.45 to 2.34)and 12 months(adjusted OR 1.59,95% CI 1.26 to 2.01)after spontaneous ICH.Conclusion The results revealed that the short-term and long-term mortality of patients with spontaneous ICH in China was significantly associated with their in-hospital medical complications.