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Differences in the distribution of stroke subtypes in a UK black stroke population – final results from the South London Ethnicity and Stroke Study

Overview of attention for article published in BMC Medicine, May 2016
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  • Good Attention Score compared to outputs of the same age (70th percentile)

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Title
Differences in the distribution of stroke subtypes in a UK black stroke population – final results from the South London Ethnicity and Stroke Study
Published in
BMC Medicine, May 2016
DOI 10.1186/s12916-016-0618-2
Pubmed ID
Authors

Giosue Gulli, Loes C. A. Rutten-Jacobs, Lalit Kalra, Anthony G. Rudd, Charles D. A. Wolfe, Hugh S. Markus

Abstract

Stroke incidence is increased in Black individuals but the reasons for this are poorly understood. Exploring the differences in aetiological stroke subtypes, and the extent to which they are explained by conventional and novel risk factors, is an important step in elucidating the underlying mechanisms for this increased stroke risk. Between 1999 and 2010, 1200 black and 1200 white stroke patients were prospectively recruited from a contiguous geographical area in South London in the UK. The Trial of Org 10172 (TOAST) classification was used to classify stroke subtype. Age- and sex-adjusted comparisons of socio-demographics, traditional vascular risk factors and stroke subtypes were performed between black and white stroke patients and between Black Caribbean and Black African stroke patients using age-, sex-, and social deprivation-adjusted univariable and multivariable logistic regression analyses. Black stroke patients were younger than white stroke patients (mean (SD) 65.1 (13.7) vs. 74.8 (13.7) years). There were significant differences in the distribution of stroke subtypes. Small vessel disease stroke was increased in black patients versus white patients (27 % vs. 12 %; OR, 2.74; 95 % CI, 2.19-3.44), whereas large vessel and cardioembolic stroke was less frequent in black patients (OR, 0.59; 95 % CI, 0.45-0.78 and OR, 0.61; 95 % CI, 0.50-0.74, respectively). These associations remained after controlling for traditional vascular risk factors and socio-demographics. Black Caribbean patients appeared to have an intermediate risk factor and stroke subtype profile between that found in Black African and white stroke patients. Cardioembolic stroke was more strongly associated with Black Caribbean ethnicity versus Black African ethnicity (OR, 1.48; 95 % CI, 1.04-2.10), whereas intracranial large vessel disease was less frequent in Black Caribbean patients versus Black African subjects (OR, 0.44; 95 % CI, 0.24-0.83). Clear differences exist in stroke subtype distribution between black and white stroke patients, with a marked increase in small vessel stroke. These could not be explained by differences in the assessed traditional risk factors. Possible explanations for these differences might include variations in genetic susceptibility, differing rates of control of vascular risk factors, or as yet undetermined environmental risk factors.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 61 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 16%
Researcher 10 16%
Student > Bachelor 7 11%
Student > Ph. D. Student 7 11%
Student > Doctoral Student 4 7%
Other 7 11%
Unknown 16 26%
Readers by discipline Count As %
Medicine and Dentistry 19 31%
Psychology 3 5%
Nursing and Health Professions 3 5%
Agricultural and Biological Sciences 2 3%
Computer Science 2 3%
Other 8 13%
Unknown 24 39%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 May 2016.
All research outputs
#6,297,587
of 22,873,031 outputs
Outputs from BMC Medicine
#2,386
of 3,438 outputs
Outputs of similar age
#99,575
of 333,293 outputs
Outputs of similar age from BMC Medicine
#29
of 37 outputs
Altmetric has tracked 22,873,031 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 3,438 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 43.6. This one is in the 30th percentile – i.e., 30% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 333,293 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 37 others from the same source and published within six weeks on either side of this one. This one is in the 21st percentile – i.e., 21% of its contemporaries scored the same or lower than it.