Publication: Estudio de la incidencia y mortalidad de la enfermedad cerebrovascular en el anciano: estudio epidemiológico poblacional en la cohorte NEDICES
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2017-02-08
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Universidad Complutense de Madrid
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Abstract
La enfermedad cerebrovascular es una de las enfermedades más incapacitantes y onerosas en todo el mundo. Se sabe además, que es un problema que se asocia a la edad. Los estudios de incidencia son muy valiosos para obtener datos con los que poder comparar, con menos sesgos, la carga de la enfermedad en un medio, además de ser esenciales para la formulación de políticas, la planificación y asignación de los recursos sociales y sanitarios, y por último, permiten además, identificar los factores de riesgo asociados con la aparición de la enfermedad. Pero la realización de estudios de incidencia es muy difícil, ya que han de cumplir una serie de criterios de estudio “ideal” descritos en la literatura. Aunque hay varios estudios de incidencia de ictus en España, este es el primer estudio prospectivo poblacional realizado en nuestro medio siguiendo estos criterios. El primero de nuestros objetivos es determinar la tasa de incidencia de enfermedad cerebrovascular, por edad y sexo, incluyendo ictus y accidentes isquémicos transitorios en tres poblaciones del centro de España usando los datos del estudio NEDICES (acrónimo en inglés de Neurological Diseases in Central Spain), un estudio poblacional longitudinal en sujetos ancianos. Hay muy pocos estudios poblacionales, ninguno realizado en España, que analicen la supervivencia a largo plazo y los factores de riesgo para fallecer tras una enfermedad cerebrovascular. Estos estudios muestran que el riesgo de muerte es mayor en el primer año tras el ictus y desciende posteriormente. El segundo objetivo es analizar la mortalidad a trece años de los sujetos con enfermedad cerebrovascular, tanto prevalente como incidente de la cohorte NEDICES. Esto incluye evaluar el riesgo de muerte e identificar los factores predictores de muerte en los sujetos con ictus, así como la magnitud del aumento de riesgo a lo largo de los años de seguimiento. Por último, los estudios poblacionales internacionales indican que las causas de muerte de los pacientes con enfermedad cerebrovascular son distintos de la población general pero difieren entre ellos. El tercer objetivo es describir las diferencias entre las causas de muerte de esos sujetos respecto a la cohorte general...
Stroke is one of the most disabling and burdensome health conditions worldwide. It is known that stroke increases with age. Incidence studies are particularly valuable for less biased comparison of disease occurrence, as well as being essential for policymaking, planning, and allocation of health and welfare resources policy makers and permit, to identify those factors casually associated with disease onset. But incidence studies are difficult to make because they must meet the “ideal” criteria proposed in the literature. Although there are some studies of stroke incidence in Spain, these is the first prospective population-based study that has been conducted in our country follows this criteria. Our aim is to assess age and age and gender incidence rates of cerebrovascular disease, including stroke and transient ischemic attack, in three populations in central Spain using data from the NEDICES (Neurological Diseases in Central Spain), a population-based survey of elderly participants. There are few population-based studies, none in Spain, that have examined the longterm survival and prognostic factors for death after stroke. These investigations show that the highest risk for death is in the first year of a stroke and then gradually declines. The second objective is to evaluate the mortality, thirteen years after de baseline wave, in prevalence survey, and ten years after the day of the stroke, in incidence survey, of participants suffering stroke in NEDICES cohort study. We want to assess the risk of mortality and the predictors of death in survivors of first-ever stroke, and the relative risk of death during the years of follow up. Finally, in these few population-based international studies, the causes of death in stroke patients are different regarding the general population but differ among them. The third objective is to know the causes of death in our stroke patients in comparison with general cohort...
Stroke is one of the most disabling and burdensome health conditions worldwide. It is known that stroke increases with age. Incidence studies are particularly valuable for less biased comparison of disease occurrence, as well as being essential for policymaking, planning, and allocation of health and welfare resources policy makers and permit, to identify those factors casually associated with disease onset. But incidence studies are difficult to make because they must meet the “ideal” criteria proposed in the literature. Although there are some studies of stroke incidence in Spain, these is the first prospective population-based study that has been conducted in our country follows this criteria. Our aim is to assess age and age and gender incidence rates of cerebrovascular disease, including stroke and transient ischemic attack, in three populations in central Spain using data from the NEDICES (Neurological Diseases in Central Spain), a population-based survey of elderly participants. There are few population-based studies, none in Spain, that have examined the longterm survival and prognostic factors for death after stroke. These investigations show that the highest risk for death is in the first year of a stroke and then gradually declines. The second objective is to evaluate the mortality, thirteen years after de baseline wave, in prevalence survey, and ten years after the day of the stroke, in incidence survey, of participants suffering stroke in NEDICES cohort study. We want to assess the risk of mortality and the predictors of death in survivors of first-ever stroke, and the relative risk of death during the years of follow up. Finally, in these few population-based international studies, the causes of death in stroke patients are different regarding the general population but differ among them. The third objective is to know the causes of death in our stroke patients in comparison with general cohort...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Fisiología, leída el 28-01-2016