Registre des AVC du pays de Brest (registre qualifié 2011-2017) FRESH-PEF241-en Serge TIMSIT Registre des AVC du pays de Brest (registre qualifié 2011-2017) BREST (The Brest REgistry of STroke) FRESH-PEF241-en 241 FRESH-PEF241 Serge TIMSIT CENTRE HOSPITALIER REGIONAL ET UNIVERSITAIRE DE BREST (CHRU) Epidemiology France Portal (PEF) INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE (INSERM) SANTE PUBLIQUE FRANCE null Serge;TIMSIT Databank Vascular risk factors Stroke transient ischaemic attack (TIA) epidemiology registry Neurology Environmental determinants: Other Behavioral determinants Healthcare system determinants: Use of care Environmental determinants Healthcare system determinants The main objective of Brest Stroke Registry is to regroup all confirmed cases of stroke over a defined geographical zone in order to calculate an incidence. There are three prospective medium-term goals: - In respect with public health epidemiology: 1- To obtain incidence data and evaluate the regional and international divergences This is about obtaining confirmed incidence data given that there are only two French data bases in Dijon and Lille. Our results put forward a high stroke incidence rate in the region of Brest. The rates of combined standardized attacks for 2008-2010 in 1 00 000 people were: For men: 356.7 (IC95%: 317,5-396.0); 445.5 (IC95%: 414.7-476.3) and 464.1 (IC95%: 415.0-513.2) for Dijon, Brest and Lille respectively. (Cf registry comparison) For women: 244.8 (IC95%: 219.7-269.8); 300.9 (IC95%: 282.9-319.0) and 362.4 (IC95%: 331.8-393.1) for Dijon, Brest and Lille respectively. (Cf registry comparison) To date, there is no explanation for this high divergence of data. 2- To obtain the mortality data in short and long term. Since the onset of the registry, we have implemented a study on the mortality of stroke patients of Brest Registry. This study has been realized independently for both types of stroke, i.e. ischemic and hemorrhagic, with different caused mortality. This mortality was studied at medium-term (≤ 28 days) as well as at long-term (> 28 days). Currently, we have followed all collected data in 2008 for a maximum of 6 years. There will be a collaboration project between InVS, Brest CHU and Rennes network on all causes of death. 3- Pharmaco-epidemiology In clinical terms, the registry offers an opportunity to do an inventory of all current practices (diagnosis, therapies and the subsidiaries) and propose in this manner the best management of stroke. This strategy is in line with the pilot programs deployed by the HAS (French High Health Authority) for improvement of quality and safety of the health care. We have a project to analyse the bleeding risk associated with anticoagulants and anti-platelet agents in people of Brest as well as that of Dijon and Lille (in collaboration with their respective registry). This study has gained a particular characteristic since 2012 with emerging new oral anticoagulants (OAC) which have shown less associated bleeding risks compared with vitamin K antagonists (randomized controlled trials). Hospital Project Call for Funding will be submitted in 2015. - In terms of clinical researc we have initiated several projects: 1- Study the impactand consequences of stroke by socio-economic characteristics of the territories in the Pays de Brest (SOCAVAC) 2- Identify short and long term clinical predictors of mortality in patients who have had a hemorrhagic stroke. 3- To identify clinical predictors of mortality in the short and long-term patients with ischemic stroke. 4- To identify genetic predictors of mortality and long-term recurrence of patients with ischemic stroke 5- Identify stroke identification algorithm from existing databases null France Bretagne Individuals Patients population Male Female Young Adult (19 to 24 years) Adult (25 to 44 years) Middle Aged (45 to 64 years) Aged (65 to 79 years) Aged, 80 and over (80 years and more) Diagnostic validated for one of the following pathologies: - Ischemic stroke, - Non-traumatic intracranial hematoma - Cerebral venous thrombosis Diagnostic after December 31, 2007 Age > 15 years on the date of the diagnostic Patient domiciled at the time of the diagnostic in one of the 79 communes defined beforehand Clinical data Socio-demographic data Paraclinical data (non-biological) : Imaging Paraclinical data (non-biological) : Function testing Health event/morbidity Health event/mortality Other [1000-10000[ individuals Interview with the participant (including clinical) Observational Study Observational Study Morbidity registry 851 in 2008 - 898 in 2009 - 823 in 2010 - 809 in 2011 - 841 in 2012 - 896 in 2013 Unknown Restricted access Collaboration required after validation by the Scientific Committee of the Registry. Access on specific project only