{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:58:45Z","timestamp":1793753925507,"version":"4.6.1"},"reference-count":21,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T00:00:00Z","timestamp":1552348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background and methods<\/jats:title>\n                    <jats:p>Stroke incidence and mortality are reported to have increased in the Middle-East and North African (MENA) countries during the last decade. This was a prospective observational study to examine the baseline characteristics of stroke patients in the MENA region and to compare the MENA vs. the non-MENA stroke cohort in the Safe Implementation of Treatments in Stroke (SITS) International Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 13,822 patients with ischemic and hemorrhagic stroke enrolled in the SITS-All Patients Protocol between June 2014 and May 2016, 5897 patients (43%) were recruited in MENA. The median onset-to-door time was 5\u2009h (IQR: 2:20\u201313:00), National Institutes of Health Stroke Scale (NIHSS) score was 8 (4\u201313) and age was 65 years (56\u201376). Hypertension (66%) and diabetes (38%) were the prevailing risk factors; large artery stenosis\u2009&gt;\u200950% (25.3%) and lacunar strokes (24.1%) were the most common ischemic stroke etiologies. In comparison, non-MENA countries displayed an onset-to-door time of 5:50\u2009h (2:00\u201318:45), a median of NIHSS 6 (3\u201314), and a median age of 66 (56\u201376), with other large vessel disease and cardiac embolism as the main ischemic stroke etiologies. Hemorrhagic strokes (10%) were less common compared to non-MENA countries (13.9%). In MENA, only a low proportion of patients (21%) was admitted to stroke units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MENA patients are slightly younger, have a higher prevalence of diabetes and slightly more severe ischemic strokes, commonly of atherosclerotic or microvascular etiology. Admission into stroke units and long-term follow-up need to be improved. It is suspected that cardiac embolism and atrial fibrillation are currently underdiagnosed in MENA countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493019830331","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T10:56:43Z","timestamp":1552388203000},"page":"715-722","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Stroke in the Middle-East and North Africa: A 2-year prospective observational study of stroke characteristics in the region\u2014Results from the Safe Implementation of Treatments in Stroke (SITS)\u2013Middle-East and North African (MENA)"],"prefix":"10.1177","volume":"14","author":[{"given":"Suhail Al","family":"Rukn","sequence":"first","affiliation":[{"name":"Department of Neurology, Rashid Hospital, Dubai Health Authority, Dubai, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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