Evidence map›Paper›PMID 42277678›Full record

Observational studyBMC neurology2026

Stroke risk factors and outcomes in Trinidad and Tobago: the START study.

Naveen Anand Seecheran, Nicole Maharaj, Steven Swarath, Anujh Maharajh, Sesh Gowrie-Sankar, Racquel Charles, Rekha Lobin, Srivane Richard, Stephanie Battersby, Krystelle Rohit and 18 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05256550 (Stroke Outcome Analysis and Registry in Trinidad and Tobago; the StART Study), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT05256550 completednot on this map

Stroke Outcome Analysis and Registry in Trinidad and Tobago; the StART Study

Typeobservational_patient_registrySponsorNaveen SeecheranRan2022 to 2023Enrolled1,320ConditionsStroke
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Suspected Transient Ischemic Attack Related to Dysfunctional Quadricuspid Aortic Valve.Journal of investigative medicine high impact case reports
    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

28 authors.

Naveen Anand SeecheranDepartment of Clinical Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago. Naveen.Seecheran@sta.uwi.edu.
Nicole MaharajDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Steven SwarathDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Anujh MaharajhDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Sesh Gowrie-SankarDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Racquel CharlesDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Rekha LobinDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Srivane RichardDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Stephanie BattersbyDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Krystelle RohitDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Shenelle NananDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Kerryn RohitDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Ravi MaharajDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Arianne LallaDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Zahra JumanDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Sheri ThackoorcharanDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Satesh BissramDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Jean-Marie FrederickDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Priya RamcharanDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Valmiki SeecheranDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Rajeev SeecheranDepartment of Medicine, Kansas University Medical Center, Wichita, KS, USA.
Lakshmipathi PeramDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Shastri MotilalDepartment of Clinical Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Stanley GiddingsDepartment of Clinical Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Sherry SandyDepartment of Clinical Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Anil RamlackhansinghDepartment of Clinical Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Nicholas MarajDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.
Avidesh PandayDepartment of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aimed to assess the risk factors, associations and outcomes of stroke at an academic tertiary medical center in Trinidad and Tobago.

methodsThis cross-sectional observational study with longitudinal follow-up evaluated 546 patients admitted with stroke at the Eric Williams Medical Sciences Complex (EWMSC) from January 2023 to January 2024. Patients' comorbidities, medications, and neuroimaging findings were recorded. Disability and survival outcomes utilizing the modified Rankin Scale (mRS) were assessed during their inpatient status and at three months post-hospitalization.

resultsThe average age represented was 65 years, with 56% males. Of a total of 546 patients who presented with acute neurologic deficits, 410 were diagnosed with a stroke, with the remaining 136 (25%) with a transient ischemic attack (TIA). Of the stroke cases, 328 (80%) were ischemic, 78 (19%) were hemorrhagic, and 5 (1%) were with ischemic lesions complicated by hemorrhagic transformation. The overall inpatient mortality rate was 16%, and the 3-month mortality rate was 26%. Gender was associated with an increased odds of having a stroke compared to a transient ischemic attack (p-value 0.036). Chronic kidney disease (CKD) was associated with an increased odds ratio (OR) of hemorrhagic stroke (OR = 11.10; 95% confidence interval (CI) 3.39-36.36, p-value 0.020). Diabetes mellitus (DM) (OR 1.72, 95% CI 1.08-2.73, p-value 0.02; OR 1.51, 95% CI 1.03-2.21; p-value 0.037), subarachnoid hemorrhage (SAH) (OR 5.45, 95% CI 1.72-17.32, p-value 0.004; OR 4.14, 95% CI 1.29-13.25, p-value 0.017), intraparenchymal hemorrhage (IPH) (OR 4.83, 95% CI 2.76-8.48, p-value < 0.001; OR 3.17, 95% CI 1.87-5.37, p-value < 0.001) and middle cerebral artery (MCA) infarct (OR 3.02, 95% CI 1.87-4.89, p-value < 0.001; OR 2.34, 95% CI 1.54-3.57, p-value < 0.001) were associated with in-hospital and 3-month mortality respectively. Atrial fibrillation (AF) (OR 2.47, 95% CI 1.08-5.64, p-value 0.031) was associated with in-hospital mortality. Age (OR 1.02, 95% CI 1.01-1.04, p-value 0.004), heart failure with reduced ejection fraction (HFrEF) (OR 4.88, 95% CI 1.15-20.68, p-value 0.032) and anterior cerebral artery (ACA) infarct (OR 2.27, 95% CI 1.13-4.56, p-value 0.022) were associated with 3-month mortality. Age was positively correlated with mRS (p-value 0.013). Ischemic stroke had a median mRS of 3, while hemorrhagic stroke had a median mRS of 5 (p-value < 0.001).

conclusionThis study demonstrated high-risk subgroups, disability and mortality outcomes in patients with stroke in Trinidad. Conventional risk factors such as age, CKD, DM, AF, and HFrEF with specific neuroradiologic findings (SAH, IPH, MCA and ACA infarcts) were all negatively associated with adverse outcomes in stroke patients in Trinidad. This information may be clinically pertinent in devising comprehensive strategies to attenuate stroke burden. Further, large-scale prospective studies are required to confirm these epidemiologic results. TRIAL REGISTRATION NUMBER: NCT05256550. This study was prospectively registered on 02/15/2022 on clinicaltrials.gov.

Indexed as

StrokeAgedCross-Sectional StudiesFemaleFollow-Up StudiesHemorrhagic StrokeHumansIschemic Attack, TransientIschemic StrokeLongitudinal StudiesMaleMiddle AgedRisk FactorsTrinidad and TobagoCerebrovascular accident (CVA)Cerebrovascular event (CVE)Hemorrhagic strokeIschemic strokeModified Rankin Scale (mRS)StrokeTransient ischemic attack (TIA)

Identifiers

PMID42277678
PMCPMC13483544

What OpenQuestion holds

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Registered trials

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.