CLINICAL PRESENTATION, RISK FACTORS AND OUTCOME OF STROKE AT A DISTRICT LEVEL TEACHING HOSPITAL

Choudhary Tariq Masood, Maqbool Hussain, Anis -ur- Rehman, Saleem Abbasi

Abstract


Background: Stroke is a fatal clinical syndrome with mortality rate ranging up to 25%. Hypertension, smoking and diabetes mellitus are common preventable risk factors which are associated with serious outcome.  Objective of this study was to determine the clinical presentation, risk factors and outcome of stroke. Methods: A cross-sectional study was conducted in the Medical Wards of DHQ Teaching Hospital, Mirpur Azad Kashmir from March 2010 to January 2011. A questionnaire was prepared in accordance with the objectives of the study. Frequency of risk factors in patients with stroke were studied. Different clinical features were also noted and response to the given treatment was checked in the form of mortality and recovery. Frequencies and percentages were calculated using SPSS-12. Results: Two hundred patients with stroke were selected. Of the total, 136 (68%) had hypertension, 55 (27.5%) were smokers, 53 (26.5%) had diabetes and 25 (12.5%) patients had ischemic heart disease. One hundred and two (51%) patients presented with headache, 99 (49.5%) developed hemiplegia and 94 (47%) had loss of consciousness. CT brain showed infarction in 144 (72%) patients while 56 (28%) had haemorrhage. Observed mortality in this study was 18 (9%) while 182 (91%) patients were discharged after treatment. Conclusion: Hypertension, smoking and diabetes mellitus are major modifiable risk factors for stroke. Headache, hemiplegia and loss of consciousness are major clinical features. Ischemic stroke is much common compared to hemorrhagic stroke. With proper care stroke is manageable satisfactorily.

Keywords: Stroke, risk factors, outcome

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References


Davenport R, Denis M. Neurological emergencies: Acute stroke. J Neurol Neurosurg Psychiatry 2000;68:277–88.

Ikeda N, Hasegawa T, Hasegawa T, Saito I, Saruta T. Awareness of the Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2000) and complications to its recommendation: Surveys in 2000 and 2004. J Hum Hypertens 2006;20:263–6.

Kaste M, Palomaki H, Sarna S. Where and how should elderly stroke patients be treated? A randomized trial. Stroke 1995;26:249–53.

American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2006;29:S43–8.

American Heart Association. Heart and Stroke Statistics 2004 update. Dallas: American Heart Association; 2004.

Almani SA, Shaikh M, Shaikh MA, Shaikh K, Rahopoto MQ, Baloch GH, et al. Stroke: Frequency of risk factors in patients admitted at Liaquat University Hospital, Hyderabad/Jamshoro. J Liaquat Uni Med Health Sci 2008;7:151–6.

Judith M, George AM, (Eds). The Atlas of heart diseases and stroke. World Health Organization and CDC, 1st ed. London: Han Way Press; 2004.

Murray CJL, Lopez AD, (Eds). Global burden of diseases and injuries. Vol-I. Harvard, MA: Harvard School of Public Health; 1996.

Adams RJ, Mckie VC, Brambilla D, Carl E, Gallagher D, Nichols FT, et al. Stroke prevention trail in sickle cell anemia. Control Clin Trials 1998;19:110–29.

Bonita R, Scragg R, Stewart A, Jackson R, Beaglehole R. Cigarette smoking and risk of premature stroke in men and women. Br Med J (Clin Res Ed) 1986;293:6–8.

Shimizu H, Kawarai T, Saji N, Tadano M, Kita Y, Tabuchi M, et al. Re-evaluation of clinical features and risk factors of acute ischemic stroke in Japanese longevity society. Kobe J Med Sci 2009;55:132–9.

Javed MA, Ahmad M, Sial MSH, Naheed T. Risk factors in stroke. Pak J Neurol 1998;4:55–8.

Sacco RL, Gan R, Boden-Albala B, Lin IF, Kargman DE, Hauser WA, et al. Leisure-time physical activity and ischemic stroke risk: the North Manhattan Stroke Study. Stroke 1998;29:380–7.

Kheelani BA, Syed NA, Maken S, Mepari UU, Hameed B, Ali S, et al. Predictors of ischemic vs hemorrhagic strokes in Hypertensive patients. J Coll Physicians Surg Pak 2005;15:22–5.


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