| 821. |
- Åsberg, Signild, 1972-, et al.
(författare)
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Reduced Risk of Death with Warfarin : Results of an Observational Nationwide Study of 20 442 Patients with Atrial Fibrillation and Ischemic Stroke
- 2013
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Ingår i: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 8:8, s. 689-695
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWarfarin is demonstrated to be superior in efficacy over antiplatelet agents (AP) for the prevention of stroke, but the relationship between warfarin and mortality is less clear. Our aim was to investigate this relationship in a large cohort of unselected patients with atrial fibrillation and ischemic stroke.MethodsThis observational study was based on patients who were discharged alive and registered in the Swedish Stroke Register in 2001 through 2005. Vital status was retrieved by linkage to the Swedish Cause of Death Register. We calculated a propensity score for the likelihood of warfarin prescription at discharge from hospital. The risk of death and 95% confidence intervals (CI) were estimated in Cox regression models.ResultsOut of the 20 442 patients with atrial fibrillation and ischemic stroke (mean age=79.5 years), 31% (n=6399) were prescribed warfarin. After adjustment for the propensity score, warfarin was associated with a reduced risk of death (0.67; 95% CI, 0.63-0.71). The crude rate (per 100 person-years) of fatal non-hemorrhagic stroke was lower in patients who received warfarin (1.60; 95% CI, 1.34-1.89) compared to those who received AP (6.83; 95% CI, 6.42-7.25). The rates (per 100 person-years) of fatal hemorrhagic stroke were 0.21 (95% CI, 0.12-0.32) and 0.43 (95% CI, 0.34-0.55) in patients prescribed warfarin and AP therapy, respectively.ConclusionsIn addition to its established benefit for stroke prevention, warfarin therapy in patients with atrial fibrillation and ischemic stroke was associated with a reduced risk of death, without an increased risk of fatal hemorrhagic stroke.
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| 822. |
- Åsberg, S., et al.
(författare)
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SEX DIFFERENCES IN STROKE CARE - OBSERVATIONS FROM THE SWEDISH STROKE REGISTER 2005-2018
- 2020
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Ingår i: International Journal of Stroke. - : Wiley-Blackwell Publishing Asia. - 1747-4930 .- 1747-4949. ; 15:Suppl. 1, s. 128-128
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aims: Previous studies of stroke management and outcome after stroke in Sweden reveal differences between men and women. Our aim was to analyze if these differences have altered over time.Methods: All stroke events registered in Riksstroke, the Swedish Stroke Register during 2005–2018 were included. We performed unadjusted and age-stratified analyzes.Results: We identified 335,183 events (161,939 women; 173,244 men). Women were older than men at stroke onset (mean age 78.1 vs. 73.3 years). In both sexes, there was an increase in the proportion of ischemic stroke patients receiving reperfusion therapy 2005–2018 (1.3–16.6% in women; 2.5–16.8% in men) and, among those with atrial fibrillation, oral anticoagulants at discharge (26.4–75.8% in women; 36.7–77.7% in men). There was an increased proportion of patients prescribed statins, but during the entire study period the proportion remained lower in women (31.7–75.3%) in comparison to men (42.6–83.5%). In addition, women were less likely to be treated at stroke or intensive care units (78.4–90.6%) than men (81.9–91.8%). In 2018, unadjusted 28-day case fatality was 14.9% in women and 10.8% in men. For patients under the age of 80, case fatality was 7.2% in both women and men.Conclusions: In this large nation-wide observational study, we report a more equal care between women and men. Still, women were less often prescribed statins and were less often treated at stroke units. One explanation to these differences could be women’s higher age at stroke onset, with a presumed frailty, but further analyzes are needed to investigate if the disparity is motivated.
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| 823. |
- Åsberg, Signild, et al.
(författare)
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Statin therapy and the risk of intracerebral haemorrhage : a nationwide observational study
- 2015
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Ingår i: International Journal of Stroke. - : John Wiley & Sons. - 1747-4930 .- 1747-4949. ; 10, s. 46-49
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The association between statin therapy and intracerebral haemorrhage is still unclear. The aim was to investigate whether prior use of statin was associated with risk of intracerebral haemorrhage.METHODS: Between 2006 and 2009, we identified 7696 cases of intracerebral haemorrhage that were first-ever strokes in the Swedish Stroke Register and 14 670 stroke-free controls that were matched on age and gender in the Population Register. Drug therapy at the time of intracerebral haemorrhage was extracted from the Drug Prescription Register. The risk of intracerebral haemorrhage with statins was estimated by conditional logistic regression.RESULTS: In cases and controls, the median age was 73 years and 53% were men. Intracerebral haemorrhage cases had higher prevalence of antithrombotic therapy, hypertension, and diabetes than controls. Statins were used by 1276 (16·6%) of the intracerebral haemorrhage cases and by 2552 (17·4%) of the controls. The crude odds ratios of intracerebral haemorrhage did not differ significantly between patients with and without statins, but after adjustment for antithrombotic therapy, hypertension, and diabetes, patients with statins had a decreased risk of intracerebral haemorrhage (odds ratio = 0·68, 95% confidence interval, 0·63-0·74). The highest proportion (>20%) of antecedent statins was seen in the 70-84 age group, for both cases and controls.CONCLUSIONS: In this matched case-controlled study, statin therapy was associated with a decreased risk of incident intracerebral haemorrhage. Future studies on risk of stroke with statin therapy after intracerebral haemorrhage are needed.
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| 824. |
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| 825. |
- Åsberg, Signild, et al.
(författare)
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Warfarin-Associated Intracerebral Hemorrhage After Ischemic Stroke
- 2014
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Ingår i: Stroke. - : American Heart Association. - 0039-2499 .- 1524-4628. ; 45:7, s. 2118-2120
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The aim was to investigate the risk of intracerebral hemorrhage (ICH) in patients with ischemic stroke taking warfarin and whether this risk changed over time.METHODS: Between 2001 and 2008, the Swedish Stroke Register registered 12 790 patients with ischemic stroke discharged on warfarin. The patients was studied in two 4-year periods (inclusion 2001-2004: follow-up until 2005 and inclusion 2005-2008: follow-up until 2009) for which rates of subsequent ICH were calculated. Adjusted hazard ratios, comparing the second period with the first period, were estimated in Cox regression models.RESULTS: Of 6039 patients, 58 patients (1.0%) in the first period and 69 of 6751 patients (1.0%) in the second period had subsequent ICH. Annual rates of ICH ranged from 0.37% in the first period to 0.39% in the second period (adjusted hazard ratio, 1.04; 95% confidence interval, 0.73-1.48).CONCLUSIONS: In this nationwide study, the risk of warfarin-associated ICH among ischemic stroke patients was low and did not change during the 2000s.
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| 826. |
- Öhman, Marie, 1958-
(författare)
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Kropp och makt i rörelse
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Body and Power in MotionThis dissertation is concerned with body and politics, or, more specifi cally body, power and governance. The central question is how specifi c individuals and bodies are constituted in the teaching of Physical Education (PE) in school. Inspired by Foucault’s work and the research fi eld that emanates from the concept of governmentality, one of the ambitions is to develop a method that facilitates the study of power and governance processes in teachers’ and students’ interactive actions and dealings. With the aid of this approach, 15 video-recorded physical education lessons in 5 Swedish nine-year compulsory schools are analysed in order to demonstrate how governance processes are included in the work and activities in terms of how the processes of governance–self-governance are staged, and the direction this takes. In using the term direction I am here referring to the content the governance is aiming towards, where the question of which subjects and bodies are constituted is of substantial interest. This means that the study not only focuses on what is done, but also on the way in which it is done, i.e. it analyses both process and content.The results show that physical exertion and the desire for physical work is a thread that runs though the analysed material. It is mainly scientifi c knowledge about the body that is referred to in actual teaching practice. This is displayed through the use of a scientifi cally inspired language when talking about the body, where effects on muscles and degrees of oxygen intake are considered in connection with the physical activities. In connection with physical exertion, pupils are encouraged to do their best, try the activities on offer, cooperate with others and face challenges. In line with the governmentality perspective’s problematisation of the process governance–self-governance, the study highlights a governance mentality that is not characterised by coercion, but is rather directed towards different components of willingness where the students are expected to be participatory, take responsibility and govern their own actions in the direction of that which is most desirable and reasonable. The willingness component appears as the actual hub of character-building, were the students ought to be physically active, should want to do their best, be willing to try, should want to show solidarity and should want to defeat the others. The process of governance–self-governance is staged as different ways of appealing to one’s willingness in the activities studied. Specifi c governance techniques are used to support and promote self-governance work, i.e. different forms of encouragement strengthen the correct action, emphasising physical exertion as pleasurable and focuses on the fact that we are all involved in a common project. In the dissertation it is shown how the body is included in a socio-political context. Through the body the individual is turned into a participant of physical projects concerned with becoming a certain kind of social citizen. The body thus symbolises the complex encounter between the individual and society. In this way the study demonstrates and highlights tendencies that are evident in modern society. It is thus a narrative that indicates how we all become part of a discourse system.
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