But have you identified EXACTLY why they died? They didn't die from stroke, they died from a type of brain damage. If you don't know where and when you will never solve Hemorrhagic strokes.
Have you worked on solving these hemorrhage cascade of death problems?
hemorrhage cascade of death (9 posts)
A Tale of Two Strokes: Hemorrhagic Cases Getting Left Behind
— "We've tried surgery, we've tried medications" -- and not much to show for it
LOS ANGELES -- Improvements over the past decades in ischemic stroke mortality haven't been mirrored by even a budge in hemorrhagic stroke prognosis, a population-based study from the Netherlands showed.In the Rotterdam Study, ischemic stroke mortality rates dropped starting around 1998 for a relative 29% reduction from 1991-1998 to 2008-2015 (29 vs 11 per 100 person-years, P<0.01).
Hemorrhagic stroke mortality rates, though, stayed steady (30 vs 25 per 100 person-years, P=0.93), Reem Waziry, MD, PhD, of Harvard T.H. Chan School of Public Health in Boston, reported here at the International Stroke Conference and online in Stroke.
"It makes sense, given the amazing advances we've had in the treatment of ischemic stroke with tPA now 25 years old and endovascular therapy now 5 years old," even though most of these therapies have been aimed at reducing disability rather than mortality, commented Ralph Sacco, MD, chairman of neurology at the University of Miami and past president of the American Heart Association.
"We've had many more failures for hemorrhagic stroke," Sacco told MedPage Today. "We don't have any major breakthroughs. We've tried surgery, we've tried medications, and we have not been as successful in altering the course for hemorrhagic stroke."
There have been some positive developments in hemorrhagic stroke recently, with the STICH trial showing improved mortality with early surgical hematoma evacuation but the MISTIE III trial missing significance for a similar approach with minimally invasive surgery plus thrombolysis.
"Although, these interventions show promise in selected samples of patients in the setting of clinical trials, these advances are not yet reflected in the setting of the general population," Waziry's group wrote in the Stroke paper.
The study assessed time trends in survival after first-ever strokes among the 14,926 participants in the long-running prospective study of middle-age and older adults getting follow-up exams every 3 to 4 years. After excluding those with a past history of stroke or an unspecified stroke diagnosis during the study period, there were 162 first-ever hemorrhagic and 988 ischemic strokes recorded from 1991 through 2015.
Limitations included low power for subgroup analyses, exclusion of unspecified strokes, and a population of mainly elderly stroke survivors.
Disclosures
The researchers and Sacco disclosed no relevant relationships with industry.
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