The Barcelona Stroke Registry

The Barcelona Stroke Registry was established to collect clinical data of h ospitalized patients with stroke, in order to study their clinical characte ristics and outcome. Data were collected over a 17-year period in 3,577 con secutive patients with first-ever stroke admitted to a stroke unit in two u niversity hospitals in the city of Barcelona (Catalonia, Spain). Patients w ere generally admitted within 48 h from stroke onset, were evaluated by a n eurologist, and clinical data were collected using a standardized protocol. All subjects underwent computerized tomography (CT) examination. Data on t he 3,577 patients revealed the following stroke subtypes: cerebral infarcti on (81%), corresponding to the varieties of atherothrombotic (39.5%), cardi oembolic (17.5%), lacunar (11%), unusual (5%), or unknown (8%); and cerebra l hemorrhage. We analyzed age distribution (mean age 66 years); risk factor s (the most frequent being hypertension, present in 54% of cerebral infarct ions and in 65% of hemorrhages); clinical manifestations (the most salient being abrupt onset in one half of the cases; high frequency of decreased co nsciousness in cardioembolic infarction; headache, seizures and nuclear pal sy in 'unusual' cerebral infarctions; vomiting and coma in hemorrhage); loc alizations by vascular territories; mechanisms of the various stroke subtyp es; complications (present in one third of patients, with a mortality of 14 %), and outcome. Two out of 3 hospitalized stroke patients are first-ever s troke sufferers. Neuroimaging shows a cerebral infarct in 86.5% of cases. C linical and laboratory investigations cannot determine the mechanism of 8% of infarcts and of 23% of hemorrhages. The high frequency of medical compli cations, mortality, and disability highlights the need to establish stroke units and stroke registries in order to perform further research into the d iagnosis and management of patients with cerebrovascular disease.