Evidence map›Paper›PMID 37749496›Full record

SynthesisBMC neurology2023

Stroke epidemiology and outcomes of stroke patients in Nepal: a systematic review and meta-analysis.

Raju Paudel, Christine Tunkl, Shakti Shrestha, Ram Chandra Subedi, Ayush Adhikari, Lekhjung Thapa, Bikram Prasad Gajurel, Avinash Chandra, Ghanashyam Kharel, Pankaj Jalan and 7 more

Open access · goldAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Observational
  5. Article
  6. Article
  7. Stroke Epidemiology in Asia.Cerebrovascular diseases extra · 2025
    Review
  8. Article
  9. Article
  10. Histopathological lesions induced by stroke in the encephalon.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 10 institutions in 3 countries.

Raju PaudelGrande International Hospital, Kathmandu, Nepal. docpaudelraju@gmail.com.
Christine TunklUniversity Hospital Heidelberg, Heidelberg, Germany.
Shakti ShresthaUniversity of Queensland, Queensland, Australia.
Ram Chandra SubediGrande International Hospital, Kathmandu, Nepal.
Ayush AdhikariTribhuvan Univerisity Teaching Hospital, Kathmandu, Nepal.
Lekhjung ThapaNational Neuro Center, Kathmandu, Nepal.
Bikram Prasad GajurelTribhuvan Univerisity Teaching Hospital, Kathmandu, Nepal.
Avinash ChandraAnnapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal.
Ghanashyam KharelNational Institute of Neurological and Allied Sciences, Kathmandu, Nepal.
Pankaj JalanNorvic International Hospital, Lalitpur, Nepal.
Subash PhuyalGrande International Hospital, Kathmandu, Nepal.
Babu Ram PokharelNepal Mediciti, Lalitpur, Nepal.
Subi AcharyaPatan Academy of Health Sciences, Lalitpur, Nepal.
Kanchan BogatiPatan Academy of Health Sciences, Lalitpur, Nepal.
Pinky JhaNepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Naresh KharbujaGrande International Hospital, Kathmandu, Nepal.
Christoph GumbingerUniversity Hospital Heidelberg, Heidelberg, Germany.
Grande International Hospital · NPAnnapurna Neurological Institute and Allied Sciences · NPPatan Academy of Health Sciences · NPTribhuvan University Teaching Hospital · NPHeidelberg University · DENepal Development Research Institute · NPNepalese Army Institute of Health Services · NPNLR Nepal · NPUniversity Hospital Heidelberg · DEUniversity of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith an increasing burden of stroke, it is essential to minimize the incidence of stroke and improve stroke care by emphasizing areas that bring out the maximum impact. The care situation remains unclear in the absence of a national stroke care registry and a lack of structured hospital-based data monitoring. We conducted this systematic review and meta-analysis to assess the status of stroke care in Nepal and identify areas that need dedicated improvement in stroke care.

methodsA systematic literature review was conducted to identify all studies on stroke epidemiology or stroke care published between 2000 and 2020 in Nepal. Data analysis was done with Statistical Package for Social Sciences (SPSS) and Comprehensive Meta-analysis (CMA-3).

resultsWe identified 2533 studies after database searching, and 55 were included in quantitative and narrative synthesis. All analyses were done in tertiary care settings in densely populated central parts of Nepal. Ischemic stroke was more frequent (70.87%) than hemorrhagic (26.79%), and the mean age of stroke patients was 62,9 years. Mortality occurred in 16.9% (13-21.7%), thrombolysis was performed in 2.39% of patients, and no studies described thrombectomy or stroke unit care.

conclusionThe provision of stroke care in Nepal needs to catch up to international standards, and our systematic review demonstrated the need to improve access to quality stroke care. Dedicated studies on establishing stroke care units, prevention, rehabilitation, and studies on lower levels of care or remote regions are required.

Indexed as

Ischemic StrokeStrokeDatabases, FactualHospitalsHumansNepalEpidemiologyOutcomesReviewStroke

Identifiers

PMID37749496
PMCPMC10519080
OpenAlexW4387019681

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.