1. First Stroke Unit in Al Ain: Five Years ExperienceBy
Ali M. Hassan, Khurram A. Siddiqui,
Jumana J.Said, Atta G. Atta, Suresh Nair and
Nagi Moussa
Stroke Care Unit,
Department of Neurology,
Al Ain Hospital, Al Ain
UAE

2. Introduction and Objectives
The very first Stroke Unit started its operation in 2007 at Al Ain Hospital which is apparently the only primary stroke unit in UAE; our team includes
Neurologists
Stroke trained nurses
Rehabilitation team (physical, occupational and speech therapists)
Psychologist
Clinical pharmacist

3. Introduction and Objectives
In addition we have interventional radiology, vascular and neurosurgery teams.
We aim to elaborate our experience here so other centers can take head start from us for opening further stroke facilities in the region.

4. Methods
We looked at the Stroke Unit database over the last 5 years from November 2007 till the end of 2012 and observed patient characteristics, stroke subtypes, risk factors and outcomes

5. Results

6. Ethnic Origin (n=1480) TOTAL 268 (18%) 119(8%) 328(22%) 734(50%)
YEAR
EMARATI
OMANIS
ARABS
ASIANS
OTHER
2007 4 3 6 18 1
2008 60 27 81
155 2
2009 56 17 62
137 7
2010 46 40
151
2011 53 72
146
2012 50 28 67
101 13
TOTAL
268 (18%)
119(8%)
328(22%)
734(50%)
34(2%)

7. Ethnic Origin

8. Gender (n=1480) YEAR MALE FEMALE 2012 213 71 2011 227 78 2010 208 50
2009
219 60
2008
258 67
2007 26 6
TOTAL
1151 (77.6%)
332(22.4%)

9. Gender Ratio

10. Age (n=1480)
YEAR
≤ 50
> 50
2012
104
180
2011
201
2010
109
149
2009
120
159
2008
153
172
2007 15 17
Total
607 (41%)
876 (59%)

11. Age

12. Event TOTAL 909 (61%) 169(11%) 231 (16%) 174 (12%) YEAR ISCHEMIC TIA
HEMORRHAGE
Mimics
2012
174 43 39 28
2011
185 26 40 54
2010
148 48 23
2009
177 22 58
2008
206 34 42
2007 19 5 3
TOTAL
909 (61%)
169(11%)
231 (16%)
174 (12%)

13. Event

14. Stroke Mimics

15. NIHSS on admission Year NIHSS ˂25 NIHSS ≥ 25 Total 1259 (88%)
2007 29 3
2008
314 11
2009
260 19
2010
227 30
2011
253 52
2012
176 59
Total
1259 (88%)
174 (12%)

16. NIHSS on admission

17. mRS: discharge YEAR > 2 ≤2 2007 9 23 2008 80 245 2009 61 218 201030
227
2011 52
253
2012 59
176
TOTAL
291 (20%)
1142(80%)

18. mRS: discharge

19. Death due to Ischemic event Death due to Hemorrhagic event
Mortality
YEAR
NUMBERS
(N=1480)
Death due to Ischemic event
Death due to Hemorrhagic event
2007 3
2008 18 8 10
2009 12 6
2010 2
2011 9 5 4
2012
Total
61 (4%)
36 (2.4%)
25(1.6%)

20. Mortality

21. Mortality

22. Risk Factors Year HTN Diabetes Smoking Dyslipidemia Cardiac TOTAL
2010
101 72 39 28
2011
190
121 67 41 50
2012
195
131 56 92 58
TOTAL
486(57%)
324 (38%)
162(19%)
161(19%)
136(16%)

23. Risk Factors

24. IV Thrombolytic therapy
Year
Number
(n=909) %
Number of mortality
2008 7
3.40% 2
2009 8
4.50% 3
2010
5.40% 1
2011 16
8.60%
2012 30
17.20%
Total 69
7.60%
9 (13%)

25. IV Thrombolytic therapy

26. IV Thrombolytic therapy

27. The cause of death was malignant middle cerebral artery infarction and complete basilar artery occlusion.
Only 3 patients had symptomatic intracerebral hemorrhage as complication of thrombolytic therapy none of which led to death.
The average door to needle time was 81 minutes, while the target time was 60 minutes, though 22 (32%) patients presented on weekends.

28. Conclusions
We report that stroke unit is essential for every hospital in this region so a dedicated team can look after these patients and improve morbidity and mortality.
In our cohort, hypertension was the most common risk factor.
Outcome in majority of our patients was excellent.
Intravenous thrombolytic therapy was successfully implemented and currently we are striving towards developing intra-arterial and mechanical thrombolytic therapies.

30. Questions & Comments Thank You