Title: Clinico-epidemiological Profile of Stroke Patients admitted in a Tertiary Care Hospital of Tripura
Authors: Dr Parimal Sarkar, Dr Subhadip Paul
DOI: https://dx.doi.org/10.18535/jmscr/v8i7.65
Abstract
Introduction: Stroke is defined as an abrupt onset of a neurologic deficit lasting for more than 24 hours due to a focal vascular cause. Globally, the incidence of stroke due to ischemia is 68%, while the incidence of hemorrhagic stroke is 32%, reflecting a higher incidence of hemorrhagic stroke in low and middle income countries. A global systematic review of population-based stroke studies has documented that the highest risk of stroke is found in East Asia, Central Europe and Eastern Europe. The estimated incidence rate of stroke in India as per different studies show that 145-154 per 1lakh per year, where as in US , it is 107 per 1 lakh per year &87% cases are ischemic stroke. Mumbai, Bangalore and Trivandrum studies revealed more no of ischemic strokes compared to hemorrhagic strokes.
Aim and Objectives: To estimate the clinico-epidemiological profile of stroke cases admitted in Agartala Government Medical College and GBP Hospital.
Materials and Methods: Cross Sectional hospital based study conducted in Department of Medicine, AGMC & GBP Hospital, Agartala within a period of January 2019 to December 2019. Data was analysed by SPSS software ver. 15 using appropriate statistical tests.
Results: Age of onset of stroke is highest in 60–75 years of life. Ischaemic stroke is the commonest occurrence in our study. Males (52%) are more affected compared to females. Rural population (41%) more affected Majority (81%) of the stroke occurs during home stay. Hypertension (47.2%) and diabetes (41.9%) are the major risk factor for the stroke. Hemiplegia and hemiparesis (70%) is the most common presentation followed by loss of consciousness (55%) & speech abnormality (35%). Seasonal variation of stroke is observed in this study as more number of hemorrhagic stroke cases seen during winter season. Higher incidence of hemorrhagic stroke (22%) is observed compared to national data of 18%.
Conclusion: Poor management of hypertension one of the major factors along with diabetes, smoking and high saturated fats in stroke incidence and mortality in low and middle class population. Reduction in LDL cholesterol using statin therapy results in decreased incidence of ischemic stroke by 16–17%.Preventive strategies for rheumatic heart disease and pregnancy in stroke in young. Seasonal variation of blood pressure probably the reason of increase incidence of ICH in winter. Vegetarians are 20% higher risk of stroke.
References
- Aho K Harmsen P Hatano S et al Cerebrovascular disease in the community: results of a WHO collaborative study1980; 58: 113-130
- Strong K, Mathers C, Bonita R. Preventing stroke: Saving lives around the world. Lancet Neurol2007; 6 : 182-7
- Strong K, Mathers C. The global burden of stroke. In: Mohr JP, Grotta JC, Wolf PA, Moskowitz MA, Mayberg MR, Von Kummer R, editors. Stroke: Pathophysiology, Diagnosis and Management.5th Philadelphia, PA: Elsevier; 2011. p. 279-89.
- Bhupendra Narayan Mahanta, Tulika Goswami Mahanta: Clinico-epidemiological profile of stroke patients admitted in a tertiary care Hospital of Assam:Clinical epidemiology and global health 2018;vol 6(3) :122-129.
- Bonita R, Beaglehole R. Stroke prevention in poor countries. Time for action. 2007;38:2871–2872.
- Pandian JD, Srikanth V, Read SJ, Thrift AG. Poverty and stroke in India. A time to act. 2007;38:3063–3069.
- Praful M Dalal et al Population based stroke survey in Mumbai, India: Incidence and 28 day case fatality: Neuro-epidemiology journal 2008;31:254–261.
- Murray C, Lopez A. Global health statistics: A compendium of incidence, prevalence and mortality estimates for over 200 conditions. Cambridge, MA: Harvard University Press; 1996.
- Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systematic review. Lancet Neurol2009; 8 : 355-69.
- Horton R, Das P. Indian health: The path from crisis to progress. Lancet2011; 377 : 181-3.
- Dalal P, Bhattacharjee M, Vairale J, Bhat P. UN millennium development goals: Can we halt the stroke epidemic in India? Ann Indian Acad Neurol2007; 10 : 130-6.
- Kamalakannan SK, Gudlavalleti ASV, Murthy Gudlavalleti VS, Goenka S, Kuper H. Challenges in understanding the epidemiology of acquired brain injury in India. Ann Indian Acad Neurol 2015; 18 : 66-70.