Abstract W P202: Comparison of Stroke in India versus USA: The Indo-US Stroke Project

BACKGROUND: There is little knowledge about differences in ischemic stroke risk factors, mechanisms, and outcomes between geographically diverse countries such as India and USA. METHODS: The Indo-US Stroke Registry/Infrastructure Development Project, jointly funded by NINDS and Indian Dept of Biotechnology, has 5 Indian centers (AIIMS Delhi; PGI Chandigarh; CMC Ludhiana; Nizam’s Hyderabad; SCTMS Kerala) and one in Boston, USA. Trained MDs and research coordinators prospectively collect data on consecutive adult patients with imaging-confirmed ischemic stroke <2wks after onset. Data is entered into a central web-based electronic database. We compared stroke demographics, risk factors, mechanisms, and outcome between the 5 Indian centers (1944 patients, Nov-2012 to July-2014) and the US center (2167 patients, Jan-2007 to Mar-2011). RESULTS: As compared to patients in India, patients in Boston, USA were older (69±15y vs 58.5±15y, p<0.001); more women (47% vs. 33%, p<0.001), and had lower admission NIHSS scores (median, IQR: 4 (2-12) v. 10 (5-15); p<001). Risk factors and stroke mechanisms, showed impressive differences (Table). The Indian patients had higher in-hospital complications (pneumonia, 13% vs. 6%, p<0.001; UTI, 10% vs. 8.5%, p=0.1), and worse 90-day outcomes (mRS score 0-3, 50% vs. 57%, p=0.001). CONCLUSION: These data provide insights into the differences in stroke between India and USA. Our results have implications concerning the limited generalizability of the results of stroke prevention trials, and suggest opportunities to reduce stroke burden in both countries. ![][1] [1]: /embed/graphic-1.gif