Of all 660 incident ischemic strokes in OXVASC, 375(56.8%) had an NIHSS score ≤2, of which 232 (61.9%) hadbeen ascertained in the TIA clinic. Of these 232 minor ischemicstrokes, only 71 (30.5%) had a diagnosis of definitestroke documented in the medical records by the referringphysician in primary care or in the emergency department.Other documented diagnoses included TIA (n=62), TIA orstroke (n=12), and cerebrovascular disease (n=12) and in 58cases, no diagnosis was specified. Of note, when excludingthese minor ischemic strokes ascertained in the TIA clinic,there was no longer a difference in the incidence of ischemicstroke with NIHSS score ≤2 between OXVASC and Dijon(standardized incidence rate 34 versus 29 of 100 000/y; IRR,1.16; 95% CI, 0.71–1.90; P=0.55).To make sure that discrepancies in the reported incidencebetween Dijon and OXVASC were not related to differencesin the threshold for clinical diagnosis of minor ischemicstrokes by study teams, the investigator responsible for thevalidation of cases in Dijon (Y.B.) assessed the case records on100 clinic-referred cases from the OXVASC Study in whicha diagnosis of stroke with NIHSS score ≤2 had been made.This investigator agreed with the diagnoses of OXVASCinvestigators in 90 cases and was uncertain in the remainder.To exclude the possibility of a shift from the diagnosis of TIAtoward that of minor stroke in OXVASC, we also comparedthe incidence of TIA between Dijon and OXVASC studiesduring the same period. The incidence of TIA was also higherin OXVASC than in Dijon, consistent with the difference inrates of minor ischemic stroke (standardized incidence rate114 versus 47 of 100 000/y; IRR, 2.40; 95% CI, 1.71–3.36;P<0.001). When considering incidence of both TIA andischemic stroke with NIHSS score ≤2, similar differenceswere observed (standardized incidence rate 201 versus 75 of100 000/y; IRR, 2.67; 95% CI, 2.05–2.48; P<0.001).
การแปล กรุณารอสักครู่..
