Ischemic stroke in Morocco: a systematic review.
Ischemic stroke
Morocco
Prehospital delay
Thrombolysis
Trial of ORG classification 10,172 in acute stroke treatment classification
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
30 Dec 2019
30 Dec 2019
Historique:
received:
05
08
2019
accepted:
05
12
2019
entrez:
1
1
2020
pubmed:
1
1
2020
medline:
17
3
2020
Statut:
epublish
Résumé
The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco. The present work is a systematic review that was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analysis". We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients' proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco. Twenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval. Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco.
METHODS
METHODS
The present work is a systematic review that was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analysis". We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients' proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco.
RESULTS
RESULTS
Twenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval.
CONCLUSIONS
CONCLUSIONS
Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco.
Identifiants
pubmed: 31888526
doi: 10.1186/s12883-019-1558-1
pii: 10.1186/s12883-019-1558-1
pmc: PMC6936047
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
349Références
Neuroepidemiology. 2018;51(1-2):104-112
pubmed: 30025394
Cerebrovasc Dis. 2010;29(6):528-37
pubmed: 20357438
Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
pubmed: 19622511
J Stroke Cerebrovasc Dis. 2018 Apr;27(4):1100-1106
pubmed: 29290532
Neuropharmacology. 2018 May 15;134(Pt B):272-279
pubmed: 29505787
J Genet. 2015 Jun;94(2):313-5
pubmed: 26174681
Rev Med Interne. 2018 Jun;39(6):408-413
pubmed: 28867531
Int J Stroke. 2019 Oct;14(7):715-722
pubmed: 30860454
Int J Neurosci. 2016;126(1):10-9
pubmed: 25453894
Clin Neurol Neurosurg. 2007 Nov;109(9):770-3
pubmed: 17719720
Stroke. 2003 Dec;34(12):2847-50
pubmed: 14605319
Acta Neurol Scand. 2013 Sep;128(3):202-12
pubmed: 23560937
Int J Neurosci. 2017 Apr;127(4):314-319
pubmed: 27426935
J Genet. 2016 Jun;95(2):303-9
pubmed: 27350673
Pan Afr Med J. 2014 Jan 20;17:37
pubmed: 24932348
JAMA. 2000 Jul 5;284(1):72-8
pubmed: 10872016
Int J Stroke. 2019 Oct 8;:1747493019874729
pubmed: 31594533
PLoS One. 2014 Feb 28;9(2):e89271
pubmed: 24586649
Presse Med. 2016 Dec;45(12 Pt 2):e457-e471
pubmed: 27816341
Int J Stroke. 2018 Oct;13(8):797-805
pubmed: 29664359
Pan Afr Med J. 2016 Jul 08;24:207
pubmed: 27795802
J Neurol Sci. 2010 Aug 15;295(1-2):38-40
pubmed: 20541222
Acta Neurol Scand. 2011 Feb;123(2):105-10
pubmed: 20637011
Pan Afr Med J. 2015 May 19;21:37
pubmed: 26405473
Meta Gene. 2014 May 07;2:349-57
pubmed: 25606419
Pan Afr Med J. 2018 Jun 12;30:114
pubmed: 30364416
Lancet Neurol. 2009 Apr;8(4):345-54
pubmed: 19233730
Ann Cardiol Angeiol (Paris). 2018 Sep;67(4):256-259
pubmed: 29753425
Ann Cardiol Angeiol (Paris). 2012 Aug;61(4):252-6
pubmed: 22626652
Eur Stroke J. 2016 Sep;1(3):180-198
pubmed: 31008279
J Neurol Sci. 2009 Sep 15;284(1-2):18-23
pubmed: 19428027
Heart. 2008 Jun;94(6):697-705
pubmed: 18308869
J Stroke Cerebrovasc Dis. 2018 Mar;27(3):625-632
pubmed: 29108809
Neurosci Bull. 2013 Dec;29(6):725-30
pubmed: 24132798
J Hypertens. 2013 Jan;31(1):49-62
pubmed: 23221932
PLoS One. 2014 Jun 26;9(6):e100724
pubmed: 24967899
Presse Med. 2008 Oct;37(10):1502-3
pubmed: 18653308