A Study of Risk Factors of Stroke in Department of Neurology at GMC/DHQ Teaching Hospital Gujranwala

  • SAJJAD NASEER DHQ Teaching Hospital Gujranwala Medical College, Gujranwala, Pakistan
  • IMRAN ASGHAR KHAN DHQ Teaching Hospital Gujranwala Medical College, Gujranwala,
  • ABDUSSLAM . DHQ Teaching Hospital Gujranwala Medical College, Gujranwala
  • JAVED IQBAL ZUBERI DHQ Teaching Hospital Gujranwala Medical College, Gujranwala
Keywords: Stroke, Cerebrovascular Disease

Abstract

Objective: To evaluate pattern and risk factors of strokes admitted in the department of neurology GMC/DHQ teaching hospital Gujranwala. Materials and Methods: This study was conducted at GMC Gujranwala during January 2018. Results: During the month of January 2018 total number of admitted patients were 400. Out of these one hundred were of stroke. Males were 61, females were 39. Mean age was 57 years while the mean hospital stay was 6.2 days. Among these 100 cases, cerebral infarction were in 54 patients and hemorrhagic in 46 patients. We observed that most of cerebral infarction were in territory of middle cerebral artery, and intracerebral hemorrhages were mostly thalamic region followed putamen. It was further seen that hypertension was the most common risk factor in 56 patients, ischemic heart disease (IHD) 28, and diabetes in 10 patients. The mortality was 20% more in patients of hemorrhagic strokes. Glasgow coma scale was an important determinant of outcome of stroke. Conclusion: Our study concluded that Ischemic Strokes are slightly higher than Hemorrhages stroke. GCS is an important determinant in the outcome of stroke. 33% of intracerebral bleeds die shortly after admission. 

References

1. Jack W. Tsao, DPhil; J. Claude Hemphill III, S. Claiborne Johnston, et al. Initial Glasgow Coma Scale Score Predicts Outcome Following Thrombolysis for Posterior Circulation Stroke. Arch Neurol. 2005; 62 (7): 1126-1129.
2. Mark T. Smith BSc, Gillian D. Baer MSc. Archives of Physical Medicine and Rehabilitation. Science Direct; April 1999; Volume 80, Issue 4: Pages 442-447. 3. Mathew J Reeves, Chery D Bushnell, George Howard, Julia Warner Gargano, Pamela W Duncan, Gwen Lynch, Arya Khatiwoda, and Lynda Lisabeth, Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol. 2008 Oct; 7 (10): 915–926.
4. Xiao-ying Yao, Yan Lin, Jie-li Geng, Ya-meng Sun, Ying Chen, Guo-wen Shi, Qun Xu, and Yan-sheng Li. Age- and Gender-Specific Prevalence of Risk Factors in Patients with First-Ever Ischemic Stroke in China.Stroke Res Treat. 2012; 2012: 136398.
5. Niewada M, Kobayashi A, Sandercock PA, Kamiński B, Członkowska A. International stroke trial collaborative group. Influence of gender on baseline features and clinical outcomes among 17,370 patients with confirmed ischemic stroke in the international stroke trial. Neuroepidemiology, 2005; 24 (3): 123–128.
6. Ayala C, Croft JB, Greenlund KJ, et al. Sex differences in US mortality rates for stroke and stroke subtypes by race/ethnicity and age, 1995-1998. Stroke, 2002; 33 (5): 1197–1201. 7. Huang Y, Wang JG, Wei JW, et al. Age and gender variations in the management of ischaemic stroke in China. International Journal of Stroke, 2010; 5 (5): 351–359.
8. Andersen KK, Andersen ZJ, Olsen TS. Age- and gender-specific prevalence of cardiovascular risk factors in 40 102 patients with first-ever ischemic stroke: a Nationwide Danish Study. Stroke, 2010; 41 (12): 2768–2774.
9. Giralt D, Domingues-Montanari S, Mendioroz M, et al. The gender gap in stroke: a meta-analysis. Acta Neurologica Scandinavica. 2012; 125 (2): 83–90.
10. Moroney JT, Bagiella E, Paik MC, Sacco RL, Desmond DW. Risk factors for early recurrence after ischemic stroke: the role of stroke syndrome and subtype. Stroke. 1998 Oct; 29 (10): 2118-24.
11. Klaus Kaae Andersen, Tom Skyhøj Olsen. Christian Dehlendorff, MS; Lars Peter Kammersgaard, MD. Hemorrhagic and Ischemic Strokes Compared Stroke Severity, Mortality, and Risk Factors. Stroke, 2009; 40: 2068-2072.
12. Hajat C, Dundas R, Stewart JA, Lawrence E, Rudd AG, Howard R, Wolfe CDA. Cerebrovascular risk factors and stroke subtypes. Differences between ethnic groups. Stroke, 2001; 32: 37– 42. 21.
13. The Oxfordshire Community Stroke Project Classification: Correlation with imaging, associated complications, and prediction of outcome in acute
ischemic stroke.Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association, February, 2003; 12 (1): 17. 1
14. Zaki Noah Hasan, Mousa Qasim Hussein, and Ghazi Farhan Haji. Hypertension as a Risk Factor: Is It Different in Ischemic Stroke and Acute Myocardial Infarction Comparative Cross-Sectional Study? Int J Hypertens. 2011; 2011: 701029.
15. Lawes C, Bennett DA, Feigin VL, Rodgers A. Blood pressure and stroke: an overview of published reviews. Stroke, 2004; 35 (3): 776–785.
16. Lakhan SE, Sapko MT. Blood pressure lowering treatment for preventing stroke recurrence: a systematic review and meta-analysis. International Archives of Medicine, 2009; 2 (1, article 30).
17. Vasan RS, Larson MG, Leip EP, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. The New England Journal of Medicine, 2001; 345 (18): 1291–1297.
18. Cífková R. Epidemiology and risk of hypertension. Archives of Medical Science, 2009; 5 (2A): S199–S211.
19. Brett M. Kissela, Jane Khoury, Dawn Kleindorfer, Daniel Woo, Alexander Schneider, MD1, Kathleen Alwell, RN1, Rosemary Miller, RN1, Irene Ewing, Charles J. Moomaw, Jerzy P. Szaflarski, James Gebel, Rakesh Shukla, and Joseph Broderick. Epidemiology of Ischemic Stroke in Patients with Diabetes. The Greater Cincinnati/Northern Kentucky Stroke Study. Diabetes Care, 2005 Feb; 28 (2): 355-359.
20. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS: Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003; 289: 76–79.
21. Jesse Weinberger, M.D., Victoria Biscarra, R.N., Michael K. Weisberg., B.S., Julius H. Jacobson, M.D. Factors Contributing to Stroke in Patients with Atherosclerotic Disease of the Great Vessels: The Role of Diabetes. Stroke, 1983; Vol. 14, No 5.
22. Klaus Kaae Andersen, Tom Skyhøj Olsen, Christian Dehlendorff, and Lars Peter Kammersgaard. Hemorrhagic and Ischemic Strokes Compared. Stroke Severity, Mortality, and Risk Factors. Stroke, 2009; 40: 2068–2072.
Published
2019-03-22
Section
Original Article