An observational study from a new tertiary care hospital in North Odisha: clinical and etiological profile of acute ischemic stroke patients
DOI:
https://doi.org/10.18203/2349-3933.ijam20194227Keywords:
Hemiplegia, Ischemic stroke, North Odisha, Risk factorsAbstract
Background: Worldwide, cerebrovascular accidents (stroke) are the second leading cause of death and the third leading cause of disability. According to WHO estimation, by 2050 nearly 80% of stroke cases may occur in low and middle-income countries like China and India. It is critical that we understand the etiology causing the stroke so that appropriate treatment can be initiated in a timely fashion. Furthermore, understanding the risk factors associated with stroke is important before primary and secondary preventive measures can be prescribed to the patient.
Methods: This observational study was carried out amongst 481 acute ischemic stroke patients that fulfils the inclusion and exclusion criteria and admitted in medicine ward of Pandit Raghunath Murmu Medical College and Hospital, Baripada, Dist. Mayurbhanj, Odisha, India from June 2018 to January 2019.
Results: In our study, 481(60.43%) patients had ischemic stroke and 315 (39.57%) patients had hemorrhagic stroke. The incidence of stroke is maximum in 51-70 years of age group which comprises of 59.46% of total patients. The average age + SD were 61.4±13.1 in our study. The most common risk factor was hypertension with 69.85% followed by dyslipidemia 51.77%. Most common clinical presentation was hemiplegia (72.35%) followed by speech involvement (59.46%). Most common site of infarct was parietal (22.25%), followed by periventricular (12.68%).
Conclusions: Most of the patients had ischemic stroke as compared to hemorrhagic stroke. It was more common in males. The study contributes to understanding of demographic characteristics, risk factors, and stroke subtypes in acute ischemic stroke. The importance of various risk factors among ischemic stroke subtypes should be stressed for prompt preventive strategies and treatment.
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References
Global Health Estimates. Geneva: World Health Organization; 2012. Available at: http://www.who.int/healthinfo/global_burden_disease/en/. Cited 2016 June 1.
Owolabi MO, Akarolo-Anthony S, Akinyemi R, Arnett D, Gebregziabher M, Jenkins C, et al.; Members of the H3Africa Consortium. The burden of stroke in Africa: a glance at the present and a glimpse into the future. Cardiovasc J Afr. 2015 Mar-Apr;26(2) Suppl 1:S27-38.
Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) and the GBD Stroke Experts Group. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014 Jan 18;383(9913):245-54.
Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009 Apr;8(4):355=69.
Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol. 2007 Feb;6(2):182-7.
Smith WS, English JD, Johnson SC. Cerebrovascular Diseases. In: Favei AS, Bravnald E, Kasper DL, Hsusor SL, Longo DL, Joneson J, et al. editors. Harrison’s principles of internal medicine.17th Ed. USA: McGraw Hills; 2008:2513-2535.
Bonita R, Mendis S, Truelsen T, Bogousslavsky J, Toole J, Yatsu F. The global stroke initiative. Lancet Neurol. 2004;3:391-3.
Allen CM. Predicting the outcome of acute stroke: A prognostic score. J Neurol Neurosurg Psychiatry. 1984;47:475-80.
Caplan LR. Terms describing brain ischemia by tempo are no longer useful: A polemic (with apologies to Shakespeare). Surg Neurol. 1993;40:91-5.
Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systematic review. Lancet Neurol. 2009;8:355-69.
Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas AM, Schroll M. Stroke incidence, case fatality, and mortality in the WHO MONICA project. World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease. Stroke. 1995;26:361-7.
Hankey GJ, Warlow CP. Treatment and secondary prevention of stroke: Evidence, costs, and effects on individuals and populations. Lancet. 1999;354:1457-63.
Stroke, World Heart Federation. The global burden of stroke. Available at: http://www.worldheartfederation.org/cardiovascular-health stroke. [Last updated on 2015 Jan 02, Last Assessed on 2015 Jul 01].
Fauci AS, Dennis L, Kasper L, Longo DL, Hauser SL, Jameson JL, et al. eds Harrison’s Principles of Internal Medicine. 20th ed. United States of America, NY: McGrawHill; 2018:3068-3079.
Pandian JD, Sudhan P. Stroke epidemiology and stroke care services in India. J Stroke. 2013;15(3):128-34.
Anand K, Chowdhury D, Singh KB, Pandav CS, Kapoor SK. Estimation of mortality and morbidity due to strokes in India. Neuroepidemiol. 2001;20:208-11.
Bansal BC, Dhamija RK, Mittal S. Trends in clinico-epidemiological correlates of stroke in the community. J Indian Acad Clin Med. 1991;5:27-31.
Nagaraja D, Gururaj G, Girish N, Panda S, Roy AK, Sarma GR, et al. Feasibility study of stroke surveillance: Data from Bangalore, India. Indian J Med Res. 2009;130:396-403.
Banerjee TK, Mukherjee CS, Sarkhel A. Stroke in the urban population of Calcutta – An epidemiological study. Neuroepidemiol. 2001;20:201-7.
Dalal PM. Burden of stroke: Indian perspective. Int J Stroke. 2006;1:164-6.
Pardiwalla FK, Yeolekar ME, Bakshi SK. Circadian rhythm in acute stroke. J Assoc Physicians India. 1993;41:203-4.
Dash D, Bhashin A, Pandit AK, Tripathi M, Bhatia R, Prasad K, et al. Risk Factors and Etiologies of Ischemic Strokes in Young Patients: A Tertiary Hospital Study in North India. J Stroke. 2014;16:173-7.
Tan KS, Navarro JC, Wong KS, Huang YN, Chiu HC, Poungvarin N, et al. Clinical profile, risk factors and aetiology of young ischaemic stroke patients in Asia: A prospective, multicentre, observational, hospital- based study in eight cities. Neurology Asia. 2014;19:117-27.
Prabhakaran S, Wright CB, Yoshita M, Delapaz R, Brown T, DeCarli C, et al. Prevalence and determinants of subclinical brain infarction: The Northern Manhattan study. Neurol. 2008;70:425-30.
Prasad BO, Sunita T, Kauser U. Acute ischemic stroke in young adults-a hospital based study in North India. Int J Biomed Research. 2015;6:113-7.
Eapen RP, Parikh JH, Patel NT. A study of clinical profile and risk factors of cerebrovascular stroke. Guj Med J. 2009;64(2):47-54.
Dhamija R, Kaintura A, Kumar M. Predictive factors for post stroke seizures. Epilepsia. 2007;48:81.
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