Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Multivariate statistics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed2001

Liver abscess after transcatheter oily chemoembolization for hepatic tumors: incidence, predisposing factors, and clinical outcome.

PURPOSE: To evaluate the incidence of, predisposing factors for, and clinical outcome of liver abscess developing in patients with hepatic tumors after transcatheter oily chemoembolization (TOCE). MATERIALS AND METHODS: During the past 6-year period, 2,439 patients with hepatic tumors underwent a total of 6,255 TOCE procedures. With a retrospective review of medical records, the authors evaluated the occurrence of liver abscess, the statistical significance of potential predisposing factors including portal vein obstruction, metastatic tumors, biliary abnormalities (type 1, simple biliary obstruction; type 2, status prone to ascending biliary infection), malignant gastrointestinal mucosal lesions, and additional gelatin sponge particle embolization in liver abscess formation, and the clinical outcome of abscess. RESULTS: Fifteen liver abscesses occurred in 14 patients (0.2%). Liver abscesses developed in three of 987 (0.3%) TOCE procedures for portal vein obstruction, three of 114 (2.6%) procedures for metastatic tumors, one of 49 (1.8%) for type 1 biliary abnormality, four of 55 (7.4%) for type 2 biliary abnormality, two of 18 (11.1%) for malignant gastrointestinal mucosal lesion, and nine of 2,108 (0.4%) for additional gelatin sponge particle embolization. Univariate and multivariate statistical analysis showed that type 2 biliary abnormality was a significant predisposing factor. The mortality related to liver abscess occurred in two patients (13.3%). Thirteen liver abscesses were successfully treated with parenteral antibiotics and percutaneous catheter drainage. However, irreversible deterioration of liver function occurred in two patients. Two of nine further TOCE procedures in three patients caused recurrent septicemia and liver abscess. CONCLUSION: The biliary abnormality prone to ascending biliary infection was the most important predisposing factor to the development of liver abscess after TOCE. Postembolic liver abscess could be effectively managed with percutaneous catheter drainage.

Anti-Bacterial Agents↗
PubMed1995

Multivariate analysis of factors influencing the functional recovery after finger replantation or revascularization.

A multivariate statistical analysis was utilized to study the influence of the four preoperative (age, mechanism of injury, level of injury, and type of amputation) and one postoperative (rehabilitation) variables on the functional recovery of the replanted or revascularized finger. Statistically significant differences are summarized as follows. The young age group have a better functional recovery due to better sensory recovery than the old age group. The crush injury group have a better functional recovery, with better scores in motion and patient satisfaction, than the avulsion injury group. The middle phalangeal injury group have a better functional recovery, with better score in motion and sensation than the proximal phalangeal injury group. There is no statistically significant difference in functional recovery between the revascularized and replanted fingers, but there is a significantly better sensory recovery in the revascularized finger. The rehabilitation group has a better functional recovery, with better score in motion, subjective symptoms, and patient satisfaction, than the nonrehabilitation group.

Adult↗
PubMed2006

Transitional cell carcinoma of the ureter: prognostic factors influencing progression and survival.

OBJECTIVES: We retrospectively evaluated prognostic factors for progression-free and disease-specific survival in a large cohort of patients with transitional cell carcinoma (TCC) of the ureter. METHODS: A single-centre series of 145 consecutive patients treated with partial resection of the ureter or nephroureterectomy between 1975 and 2004 was evaluated. Median follow-up was 96 mo. Routine preoperative laboratory parameters as well as clinical and tumour-specific data were assessed. Univariate and multivariate statistical analyses were performed. RESULTS: Five-year disease-specific survival ranged from 96.1% for stages pTa to 28.6% for pT4. Grade1 tumours were associated with 5-yr disease-specific survival rates of 100% compared with 84% for G2, and 51.9% for G3 tumours, respectively. Univariate analyses identified pT stage and grade, tumour diameter, cM and pN categories, weight loss, the presence of synchronous tumour in the renal pelvis as well as elevated levels for humoral factors such as serum alkaline phosphatase (AP), white blood cell (WBC) count, platelet count, gamma-glutamyl transferase, creatinin, and blood urea nitrogen as prognostic factors. In multivariate analyses, tumour grade and WBC counts were predictive for low progression-free survival rates, whilst simultaneous tumour in the renal pelvis, high AP levels, and WBC counts were correlated with worse disease-specific survival. CONCLUSIONS: Our retrospective analysis provides clinical factors to identify patients with TCC of the ureter at high risk for progression and death of disease. Interestingly, humoral factors such as elevated serum AP levels and high WBC counts were demonstrated to be of paramount prognostic significance besides tumour stage, grade and multifocality.

Adult↗
PubMed2001

Cost consequences of sentinel lymph node biopsy in the treatment of breast cancer. A preliminary analysis.

OBJECTIVES: To assess whether sentinel lymph node biopsy (SLNB), an alternative to axillary lymph node dissection in treating female breast cancer, affords any cost savings. METHODS: We profile cumulative treatment costs of 811 breast cancer patients, 555 of whom received SLNB. Univariate and multivariate statistical tests are used to appraise whether these cost profiles differ between SLNB and other patients. RESULTS: The statistical results are mixed. However, none supports the conjecture that SLNB necessarily lowers the cost of treating the average breast patient. CONCLUSIONS: SLNB may be cost-effective, but longer term costs and outcomes must be estimated before firm conclusions can be reached.

Axilla↗
PubMed2003

Predictive value of morphologic parameters for successful correction of Class II Division 2 malocclusion.

The aim of this study was to assess the predictive value of pretreatment cephalometric parameters and apical base size for successful correction of Angle Class II Division 2 malocclusion. Pretreatment lateral cephalograms and pretreatment and posttreatment study casts of 96 subjects with Class II Division 2 malocclusions were examined to obtain 23 cephalometric parameters and to measure the size of the apical bases. Success of occlusal correction was evaluated as the percentage of change of peer assessment rating scores during treatment; percentage of change was the dependent variable in multivariate statistical analyses used to test the predictive value of the assessed parameters. Cephalometric parameters of pretreatment craniofacial morphology were insignificant as predictors of successful orthodontic correction of the malocclusions. Maxillary apical base size was the strongest predictor of occlusal correction and might serve as a valuable diagnostic predictor of successful treatment outcome.

Cephalometry↗
PubMedDate not supplied

Use of infertility services in the United States: 1995.

CONTEXT: Both the demand for and the availability of infertility services in the United States increased during the 1980s and early 1990s. Understanding the factors that are related to service-seeking among women with current fertility problems would aid efforts to better provide services. METHODOLOGY: Data on U.S. women's use of infertility services were taken from the 1995 National Survey of Family Growth, a nationally representative survey of 10,847 women aged 15-44. For the 1,210 women who at the time of the interview reported having fertility problems, multivariate statistical modeling was used to identify the characteristics associated with their use of infertility services. RESULTS: Of the 6.7 million women with fertility problems in 1995, 42% had received some form of infertility services. The most common services ever received among these women were advice (60%) and diagnostic tests (50%), medical help to prevent miscarriage (44%) and drugs to induce ovulation (35%). The proportions of fertility-impaired women who had ever received infertility services were generally highest among those who were older, who had ever been married, who had graduated from college, who had a high income and who were non-Hispanic white. Multivariate analyses reveal that apparent differences by age and race or ethnicity in the unadjusted analysis disappear once the effects of women's marital status, income and private health insurance coverage are taken into account. CONCLUSION: Women who have ever used infertility services continue to represent a select group from among those with impaired fertility. Moreover, the vast majority of women with fertility problems who seek services receive noninvasive treatments that could be considered "low technology" interventions.

Adolescent↗
PubMed1991

Multivariate procedures to describe clinical staging of melanoma.

Analyzing multivariate clinical data to identify subclasses of patients being treated for a specific disease may improve patient management and increase understanding of the behavior of disease under clinical conditions. In some cases, patients have been classified on prognostic characteristics using standard risk assessment procedures (e.g., Cox' regression). This requires long term follow-up, differentiates patients only on attributes relevant to survival, and assumes that patients are sampled from a common population. Other approaches involve the use of clustering algorithms to classify patients into categories based on multiple clinical attributes. We illustrate the use of a multivariate statistical procedure to directly characterize patients on multiple clinical characteristics. The procedure is designed to analyze discrete response data with parameters representing individual differences within groups. Its use is illustrated for patients with Stage I melanoma in determining how age is related to treatment response in different patient groups.

Adult↗
PubMed1997

Laparoscopic or open splenectomy for hematologic disease: which approach is superior?

BACKGROUND: This study was undertaken to compare safety, outcome, and costs of laparoscopic (LS) and open splenectomy (OS) for a variety of hematologic diseases. STUDY DESIGN: The records of 137 patients who underwent splenectomy (63 LS and 74 OS) at a large private teaching hospital between March 1991 and April 1996 were reviewed retrospectively. Diagnosis, age, gender, operative time, blood loss, splenic weight, time to resumption of oral diet, postoperative hospital stay, morbidity, mortality, and costs (direct and operative) were analyzed by multivariate statistical analysis. RESULTS: Laparoscopic splenectomy patients had significantly shorter hospitalization and time to resumption of an oral diet (p < 0.01); although operative costs were higher, total direct costs were not. Idiopathic thrombocytopenic purpura patients had earlier resumption of an oral diet after LS, shorter postoperative stay, and comparable OR time. Five patients (7%) were converted, with outcomes similar to OS except for greater operative time and cost. Grade II complications occurred in three LS and four OS patients; Grade III in three OS patients; and Grade IV in two OS patients. There were two major complications of LS and eight of OS, with two deaths. Multivariate analysis showed that operative time and time to resumption of oral intake were significantly related to age, diagnosis, operative technique, and splenic weight. Duration of postoperative hospitalization was related to operative technique, splenic weight, and major complications. Costs (direct and operative) were related to age, splenic weight, and major complications, but not to operative technique. CONCLUSIONS: LS results are influenced by splenic weight, disease, and age. Splenic weight appears to be the crucial determinant of operative time and length of hospitalization. LS is a superior treatment for patients with idiopathic thrombocytopenic purpura and patients with small spleens.

Adolescent↗
PubMed2003

Increased use of lipid-lowering therapy in patients receiving human immunodeficiency virus protease inhibitors.

Although human immunodeficiency virus (HIV) protease inhibitors (PIs) improve survival in patients with HIV infection, many patients receiving PIs develop hyperlipidemia, which may increase risk of future coronary events. The purpose of this study was to estimate the changing prevalence of lipid-lowering therapy (LLT) in patients with HIV and to evaluate its association with the use of HIV PIs. This was a cross-sectional study of adults with HIV infection who were registered in the Medicaid of California (MEDI-CAL) administrative claims database. Frequencies of HIV-related and dyslipidemia diagnoses were determined from International Classification of Diseases-9th Edition codes. Use of lipid-lowering and antiretroviral medications was determined by National Drug Codes. Multivariate statistical techniques were used to evaluate trends in use of PIs and lipid-lowering medications from January 1996 to June 2002. The number of HIV-infected patients in MEDI-CAL ranged from 15,764 in 1996 to 13,349 in 2000. The prevalence of LLT use among HIV-infected patients on PIs increased by sixfold (1.7% to 10.6%, p <0.05), and in 2000, exceeded use in the overall MEDI-CAL population (p = 0.09). The increasing rate of LLT in patients taking PIs was greater than in HIV-infected patients not on PIs and in MEDI-CAL (p = 0.002). In multivariate models, increasing age (odds ratio 2.30) and use of PIs (odds ratio 2.08) predicted use of LLT (p <0.001). Thus, in patients taking HIV PIs, use of LLT increased more than sixfold, at a faster rate than in the general population. It has not been proved that use of LLT in HIV-infected patients taking PIs improves survival.

Adult↗
PubMed2001

Enoxaparin in unstable angina/non-ST-segment elevation myocardial infarction: treatment benefits in prespecified subgroups.

BACKGROUND: Two large-scale phase III clinical trials, the Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events (ESSENCE) trial and the Thrombolysis in Myocardial Infarction (TIMI) 11B study, have shown the low-molecular-weight heparin, enoxaparin, to be more effective than unfractionated heparin (UFH) in reducing the risk of death and severe cardiac events in patients with rest unstable angina and/or non-ST-segment elevation myocardial infarction (NSTEMI). However, patients with NSTEMI acute coronary syndromes are a heterogeneous group. METHODS: A meta-analysis using pooled data from ESSENCE and TIMI 11B was performed to examine the efficacy of enoxaparin in different patient subgroups. In addition, a statistical model was developed to test which factors best predicted an enhanced treatment effect. RESULTS: Enoxaparin was more effective than intravenous dose-adjusted UFH in reducing the incidence of the composite endpoint (including death, myocardial infarction or recurrent angina prompting urgent revascularization) in the majority of subgroups at 43 days after randomization. Univariate analyses revealed that there was a greater benefit with enoxaparin in patients with ST-segment deviation or elevated cardiac enzyme markers on admission, women, nonsmokers and patients with characteristics indicative of higher cardiac risk, including prior percutaneous coronary interventions, being at least 65 years old, prior angina and prior aspirin use. Multivariate statistical modelling of treatment effect revealed that ST-segment depression and electrocardiographic changes were the best predictors of an enhanced treatment effect. CONCLUSIONS: These data reinforce previous evidence suggesting that enoxaparin administered subcutaneously twice daily may be considered as an alternative to intravenous UFH in the acute treatment of a broad range of patients with unstable coronary artery disease.

Adult↗
PubMed2006

Gender and recovery after general anesthesia combined with neuromuscular blocking drugs.

Previous studies suggest that women recover faster from general anesthesia than men, but it is unclear whether this is a result of a gender effect or differences in the pattern of drug administration or type of surgery. We performed a subset analysis comparing recovery characteristics from general anesthesia combined with neuromuscular blocking drugs of female and male patients, at risk of awareness, enrolled in a large trial testing the effectiveness of bispectral index (BIS) monitoring. We used multivariate statistical methods to adjust for differences in baseline characteristics, duration and extent of surgery, and anesthetic drug administration in 1079 patients (584 male, 495 female). Female patients had higher BIS values than male patients despite similar amounts of anesthetic drug administration (time-averaged mean [sd] BIS: male 44.6 [7.1] versus female 46.4 [6.6]; P = 0.005). Time to eye opening after anesthesia and time to eligibility to discharge from the postanesthesia care unit were less in women than men (male 13.9 [13.2] min versus female 10.6 [11.6] min; P < 0.001; male 133 [209] min versus female 78 [106] min; P < 0.001, respectively). These differences persisted after multivariate adjustment (both P < or = 0.001). Gender has an independent effect on recovery times in patients undergoing general anesthesia combined with neuromuscular blocking drugs, with women recovering faster than men. Higher BIS values during maintenance of anesthesia in women, despite similar amounts of anesthetic drug administration, suggests that women are less sensitive to the hypnotic effect of anesthetic drugs than men and may help explain faster recovery times in women.

Adult↗
PubMed2006

Characterization, source identification and apportionment of selected metals in TSP in an urban atmosphere.

To understand the metal distribution characteristics in the atmosphere of urban Islamabad, total suspended particulate (TSP) samples were collected on daily 12 h basis, at Quaid-i-Azam University campus, using high volume sampler. The TSP samples were treated with HNO(3)/HClO(4) based wet digestion method for the quantification of eight selected metals; Fe, Zn, Pb, Mn, Cr, Co, Ni and Cd by FAAS method. The monitoring period ran from June 2001 to January 2002, with a total of 194 samples collected on cellulose filters. Effects of different meteorological conditions such as temperature, relative humidity, wind speed and wind direction on selected metal levels were interpreted by means of multivariate statistical approach. Enhanced metal levels for Fe (930 ng/m(3)), Zn (542 ng/m(3)) and Pb (210 ng/m(3)) were found on the mean scale while Mn, Cr, Co and Ni emerged as minor contributors. Statistical correlation study was also conducted and a strong correlation was observed between Pb-Cr (r=0.611). The relative humidity showed some significant influence on atmospheric metal distribution while other meteorological parameters showed weak relationship with TSP metal levels. Regarding the origin of sources of heavy metals in TSP, the statistical procedure identified three source profiles; automobile emissions, industrial/metallurgical units, and natural soil dust. The metal levels were also compared with those reported for other parts of the world which showed that the metal levels in urban atmosphere of Islamabad are in exceedence than those of European industrial and urban sites while comparable with some Asian sites.

Air↗
PubMed2001

[An exploratory positioning analysis: three-mode multivariate analysis for semantic differential data].

The purpose of this study was to propose an exploratory positioning analysis method based on a three-mode multivariate statistical model for analyzing semantic differential (SD) data. This new method can be easily implemented by using a structural equation modeling (SEM) program such as LISREL and CALIS, because the mean structure and covariance structure of this method are expressed as submodels of SEM. Two necessary conditions for checking identifiability of this model are shown. It is also shown that this model is scale equivariant for SD data.

Humans↗
PubMed1990

Fine structure of mitochondrial helical filaments revealed by computer image analyses.

In order to clarify the fine structure of the helical filaments appearing in the outer compartment of the mitochondria, Sprague-Dawley strain male rats were given 30% ethanol in drinking water for 90 days. The hepatic tissues of these animals were fixed with perfusion of glutaraldehyde via the portal vein followed by immersion in OsO4 and were then routinely processed for preparation of thin sections. Transmission electron micrographs of the sections were used for computer image analyses of the intramitochondrial helical filaments. With the application of the image analysis, it was revealed that the helical filaments show a right-hand rotating helix of 4.3 nm in thickness, 13.2 nm in diameter of the helix, and 15.7 nm in pitch. Also, with the multivariate statistical analysis and classification method of the IMAGIC image processing system, it was suggested in the classified images that the helical filament has substructures of rod-shaped particles of 4.3 nm in diameter. These particles are considered to be connected to each other and forming the helical structure of the filament.

Animals↗
PubMed1994

Prognostic factors in mucoepidermoid carcinomas of major salivary glands: a clinicopathologic and flow cytometric study.

Mucoepidermoid carcinomas (MEC) of the major salivary glands from 48 patients who received their treatment at a single institution were studied for prognostic indicators. Uni- and multivariate statistical analyses were performed on several clinicopathologic factors and also on flow cytometric (FCM) DNA content data of the carcinomas. Clinical prognostic factors associated with decreased survival included age > 60 years (P = 0.01), male gender (P = 0.002), symptoms at diagnosis (P = 0.03), stage of disease (P < or = 0.0001), type of surgery (P = 0.0006), and recurrence (P = 0.0001). Histopathological prognostic factors associated with decreased survival included MEC tumour grade (P = 0.0001), tumour size > 3.0 cm (P = 0.02), lymph node involvement (P = 0.0004) and positive surgical margins (P = 0.007). DNA FCM factors associated with decreased survival included aneuploid tumours (P = 0.08) and proliferative activity (S+G2M > 5%, P = 0.07). Multivariate analysis indicated that histological grade, proliferative activity, symptoms at diagnosis, clinical stage of disease and type of surgery were significant (P < or = 0.05) prognostic/survival factors in the biological assessment of this neoplasm.

Adolescent↗
PubMed1998

Prognosis of intravesical bacillus Calmette-Guerin therapy for superficial bladder cancer by immunological urinary measurements: statistically weighted syndrome analysis.

PURPOSE: The goal of this research was to discover new biological indicators in urine which could be used for short-term prognosis of local Bacillus Calmette-Guerin (BCG) therapy outcome in patients with superficial bladder cancer. PATIENTS AND METHODS: We measured and statistically evaluated soluble immunological molecules in urine from bladder cancer patients (n = 34) receiving BCG intravesically. Urine was collected following each of 6 weekly treatments, processed and assayed. The data base included measurements of interleukin-1 (IL-2, IL-4, IL-6, IL-10, IL-12, soluble intercellular adhesion molecule-1 (sICAM-1), tumour necrosis factor-alpha (TNF alpha), soluble CD14 (sCD14), interferon-gamma (IFN gamma), GM-CSF, volume of urine and its pH. The clinical response was evaluated by urine histology and random quadrant biopsy 3 months after the start of therapy. Patients were divided into 2 groups, with good and poor therapeutic effect. The initial complete response rate was 62% (21/34). The data base was analyzed using traditional multivariate statistical methods and a pattern recognition method which deals with combinatorial-statistical analysis (statistically weighted syndromes (SWS) method) of the gradated features. The SWS method is capable of identifying robust patterns in small "fuzzy" sets with high dimensional objects and some missing values. RESULTS: Only one parameter gave significant differences at p < 0.05, GM-CSF at instillation 6. Repeated measurement analysis of variance, backward stepwise multiple logistic regression and linear discriminant analysis failed to show any significance. However, significant differences in the structure of correlation between features in the groups with and without therapeutic effect were observed and four highly informative variables (the masses of sICAM-1, TNF alpha, sCD14 and pH) relating to 5th-6th installations were selected by SWS. These features provided accurate individual prediction of therapeutic outcome for all our patients. Cross-validation analysis and computer simulation showed the statistically significant stability of the prediction. CONCLUSION: We have selected a set of urinary variables that could be considered as a perspective combination of indicators (syndromes) of outcome of pre-operation BCG therapy of patients with superficial bladder cancer. A larger patient database will provide testing and evaluation of the biological and clinical significance of selected features. The computational syndrome-disease approach should be applicable for the solution of decision-making problems for management of cancer.

Adjuvants, Immunologic↗
PubMed2006

Does a failed quit attempt reduce cigarette consumption following resumption of smoking? The effects of time and quit attempts on the longitudinal analysis of self-reported cigarette smoking intensity.

California Tobacco Survey respondents were asked the intensity of their cigarette smoking 1 year previously and at the time of the survey. Respondents reported a generally lower smoking intensity at survey time compared with 1 year previously. Multivariable statistical models on the change in smoking intensity in the past year were fitted to assess the effects of low-tar cigarette use, a quit attempt in the past year, smoking intensity 1 year previously, and demographic variables (age, education, income, and race). The most important predictor of change in intensity was the intensity 1 year previously. The next most important predictor was whether a quit attempt had been made in the previous year. The demographic variables also were found to have a significant effect, although their effects were of smaller magnitude. Low-tar cigarette use was not a significant predictor of change in intensity in multivariable analysis. The effect of a quit attempt on the reduction in intensity of smoking suggests that periods of cessation may reduce the intensity of smoking and the level of addiction for several months following relapse. Consequently, it may be important to control for cessation activity in studies comparing exposures from conventional tobacco products to exposures from new products that purport to offer lower harm.

Attitude to Health↗
PubMed2002

Guideline compliance improves stroke outcome: a preliminary study in 4 districts in the Italian region of Lombardia.

BACKGROUND AND PURPOSE: Guidelines for medical practice in stroke have been proposed in different countries, but their impact on stroke outcome has not been verified to date. The aim of this study was to evaluate the impact of the American Heart Association guidelines for acute stroke and for transient ischemic attack on first-ever stroke patients. METHODS: Three hundred eighty-six first-ever ischemic stroke patients were admitted to the study. Those observed within 6 hours from stroke onset were eligible for the acute clinical phase of the study, while all were admitted to the early clinical phase. The follow-up lasted 6 months. Primary end points were survival and the effectiveness of treatment on disability, measured as the proportion of potential improvement in the Barthel Index score achieved during treatment. A rating of noncompliance with the guideline recommendations was calculated for each patient, and its association with the end points was investigated. The Kaplan-Meier method and log-rank test were used to estimate and compare survival curves between groups; Cox proportional hazards model and logistic regression were used to identify risk factors for mortality; and correlation tests and regression analysis were used to evaluate the influence of guideline compliance on disability. Both univariate and multivariate statistical analyses were performed. RESULTS: Survival and treatment effectiveness were directly correlated with guideline compliance. The relative risk of death for patients with a noncompliance rating > or =5 was 2.26 with respect to patients with a noncompliance rating <5 (95% CI, 1.51 to 4.67; P<0.0007). In this latter group, at 6 months we detected a 15% decrease in mortality (95% CI, 9.1% to 17.5%). Treatment effectiveness showed a Spearman's rank correlation with the noncompliance rating of -0.3 (P<0.001). At discharge we observed a 13% increase in treatment effectiveness, while no significant differences were detectable at 3 and 6 months. These associations were confirmed by the multivariate analysis, in which we included, together with the noncompliance rating, all the variables previously identified as independent predictors of mortality and disability. CONCLUSIONS: This study demonstrates an association between adherence to guidelines and stroke outcome, and it can be viewed as a study that prepares the way for a randomized controlled trial in this area. It also emphasizes the need to develop personnel and structures devoted to stroke care because an evidence-based clinical approach could significantly reduce the risk of death.

Aged↗