A PROSPECTIVE OBSERVATIONAL STUDY ON RISK FACTORS AND MANAGEMENT OF STROKE AT A TERTIARY CARE TEACHING HOSPITAL
Objectives: To determine the prevalence of stroke and its management with various risk factors, i.e. non-modifiable and modifiable at a tertiary care teaching hospital.
Methods: It is a prospective and observational study conducted over a period of six months including established cases of stroke. The study was carried out in100 patients to evaluate risk factors and management of stroke. The data obtained with the designed data collection form were analyzed using Odds ratio and Chi-Square test.
Results: Ischemic stroke accounted for 70% of cases followed by Intracerebral Hemorrhage (20%) Subarachnoid hemorrhage (5%) and Transient Ischemic Attack (5%). Out of 100 patients, there were 74 male and 26 female patients, indicating males at higher risk. Majority of patients were between the age group 41-60 y. based on the Odds ratio hypertensive and alcoholics were more prone to stroke occurrence and recurrence. Chi-Square test performed for age and gender was not significant at significance level P<0.05.
Conclusion: In this study, ischemic stroke was most prevalent. Hypertension was the major risk factor indicating strong evidence of stroke occurrence and recurrence. The factors having the major implication in the development of stroke were Hypertension, Alcoholism, Smoking, Diabetes Mellitus, Epilepsy, Coronary Artery Disease, Tobacco, and others. Proper management includes non-pharmacological (physiotherapy) along with pharmacological treatment (Osmotic diuretics were most commonly prescribed followed by hypolipidemics, cognition enhancers, anticoagulants, dual antihypertensive therapy).
2. Tapas Kumar Banerjee, Shyamal Das. Fifty years of stroke researches in India. Ann Indian Accad Neurol 2016;19 suppl 1:11-8.
3. www.stroke.ahajournals.org. [Last accessed on 20 Dec 2017]
4. www.cdc.gov/stroke/typesofstroke.html. [Last accessed on 20 Dec 2017].
5. http://www.merckmanuals.com/professional/neurologicdisorders/stroke/transient-ischemic-attack-tia. [Last accessed on 20 Dec 2017].
6. Chachu Kuriakose, Naseem Shifafiya M, Nelta S Tharakan, Sattanathan K, Sambath Kumar R. A prospective study of clinical profile of stroke in a tertiary care hospital. Asian J Pharm Clin Res 2016;9:178-81.
7. Laxman Wagle, Abel Abraham Thomas, Sunil Shrestha. Drug utilisation study of stroke and other patients admitted to general ward of neurology unit at quaternary care private hospital. Int J Curr Pharm Res 2017;9:23-8.
8. Sahbanathul Missriya MA, Johncey John. Assess the prevalence of hypertension and knowledge regarding the prevention of stroke. Asian J Pharm Clin Res 2017;10:177-80.
9. Parveen Rashid, Jo Leonardi Bee, Philip Bath. Blood pressure reduction and secondary prevention of stroke and other vascular events a systematic review. Stroke 2003;34:2741-48.
10. Gary Friday, Milton Alter, Sue Min Lai, JO Connell, E Sobel. Hypertension and risk of stroke recurrence. Stroke 2002;33:2652-7.
11. Larsson SC, Wallin A, Wolk A, Markus HS. Differing association of alcohol consumption with different stroke types: a systematic review and meta analysis. BMC Med 2016;14:178.
12. Abbott RD, Yin Y, Reed DM, Yano K. Risk of stroke in male cigarette smokers. N Engl J Med 1986;18:717-20.
13. Viti Kothari, Richard J Stevens, Amanda I Adler, Irene M Stratton, Susan E Manley, H Andrew Neil, et al. Risk of stroke in type 2 diabetes estimated by the UK prospective diabetes study risk engine. Stroke 2002;33:1776-81.
14. Thomas S Bowman, Howard D Sesso, Jing Ma, Tobias Kurth, Carlos S Kase, Meir J Stumpfer, et al. Cholesterol and the risk of ischemic stroke. Stroke 2003;34:2930-4.