scholarly journals EVALUATION OF RISK FACTORS AND TREATMENT PATTERNS OF CVA

2021 ◽  
Vol 9 (02) ◽  
pp. 136-143
Author(s):  
Gyana Deepa.T ◽  
◽  
Vaishnavi V. ◽  
Sahithi V. Pharm D. ◽  
CH. Sridevi ◽  
...  

Back ground: Cerebro Vascular Accident is a rapidly developing signs of focal disturbances which lasts for more than 24hours and is divided into 3 types- Ischemic stroke, Hemorrhagic stroke, Transient ischemic stroke. Objective: To assess drug treatment pattern of anti-platelets, the involvement of clinical pharmacist to improve the patient outcome, the risk factors of stroke and monitor the risk of anti-platelets. Methods and methodology: A hospital based prospective observational study is conducted in neurology and general medicine department for 6 months meeting the inclusion criteria by obtaining information from the case sheets, laboratory reports and on an interview with the patient. Discussion: Among 80 patients, most of the cases reported were from the age group of 51-60yrs and males were more prone to stroke. Ischemic stroke is seen majorly and strokes are mostly diagnosed with MRI,CT scan, ECG and were treated with Aspirin and Atorvastatin (symptomatic treatment). Conclusion: Stroke (Cerebro Vascular Accident) is the second leading cause of death. Major risk factors of stroke include hypertension and diabetes mellitus. Prevention of these diseases can prevent stroke. People with these diseases are risk factors to stroke.With lifestyle modifications and medication adherence can reduce the risk of stroke. According to the study, majority of patients were males, people who smoke and consume alcohol are also prone to stroke. In this study, we dealt with the risk factors of stroke and its treatment options and lifestyle modifications which can prevent the risk of stroke.

Author(s):  
Suvvada Vamsi Jagannath ◽  
D. Vijayalakshmi

Background: Stroke, as a one of the leading causes of mortality and disability, is also very preventable and curable disease. Pharmacotherapy plays an important role in prevention of first-ever stroke as well as secondary cerebrovascular accident. We aimed to evaluate the prescription pattern in cases of ischemic stroke and to check whether rationale prescription of drugs in ischemic stroke patients is being followed in our hospital.Methods: A prospective observational study was conducted in inpatient department of general medicine in government general hospital, Kakinada for a period of six months from April to September 2018. A total of 306 prescriptions of ischemic stroke were selected randomly and prescriptions patterns were assessed and analyzed.Results: Out of the 306 cases, 183 were males (59.80%) and 123 were female (40.19%). Aspirin was given in 88.23% of the patients, Atorvastatin in 97.05%, Clopidogrel in 24.50%, antihypertensives in 67.64%, B complex in 88.23%, Pantoprazole in 85.29% of the patients. Physiotherapy was advised in 47.05% of the patients. Among anti hypertensives, Amlodipine was given in 73.91% patients.Conclusions: Anti hypertensives, lipid lowering agents like Atorvastatin along with anti-platelet drugs like Aspirin and Clopidogrel were commonly prescribed for ischemic stroke cases for treatment and secondary prevention. Antacids and Multivitamin tablets were given as concomitant drugs. Present study showed a rationale utilization of drugs in ischemic stroke patients.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.


2016 ◽  
Vol 134 (6) ◽  
pp. 543-554 ◽  
Author(s):  
Alessandra Carvalho Goulart ◽  

ABSTRACT CONTEXT AND OBJECTIVE: Stroke has a high burden of disability and mortality. The aim here was to evaluate epidemiology, risk factors and prognosis for stroke in the EMMA Study (Study of Stroke Mortality and Morbidity). DESIGN AND SETTINGS: Prospective community-based cohort carried out in Hospital Universitário, University of São Paulo, 2006-2014. METHODS: Stroke data based on fatal and non-fatal events were assessed, including sociodemographic data, mortality and predictors, which were evaluated by means of logistic regression and survival analyses. RESULTS: Stroke subtype was better defined in the hospital setting than in the local community. In the hospital phase, around 70% were first events and the ischemic subtype. Among cerebrovascular risk factors, the frequency of alcohol intake was higher in hemorrhagic stroke (HS) than in ischemic stroke (IS) cases (35.4% versus 12.3%, P < 0.001). Low education was associated with higher risk of death, particularly after six months among IS cases (odds ratio, OR, 4.31; 95% confidence interval, CI, 1.34-13.91). The risk of death due to hemorrhagic stroke was greater than for ischemic stroke and reached its maximum 10 days after the event (OR: 3.31; 95% CI: 1.55-7.05). Four-year survival analysis on 665 cases of first stroke (82.6% ischemic and 17.4% hemorrhagic) showed an overall survival rate of 48%. At four years, the highest risks of death were in relation to ischemic stroke and illiteracy (hazard ratio, HR: 1.83; 95% CI: 1.26-2.68) and diabetes (HR: 1.45; 95% CI: 1.07-1.97). Major depression presented worse one-year survival (HR: 4.60; 95% CI: 1.36-15.55). CONCLUSION: Over the long term, the EMMA database will provide additional information for planning resources destined for the public healthcare system.


2017 ◽  
Vol 13 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Alijan A Ahangar ◽  
Payam Saadat ◽  
Behzad Heidari ◽  
Seyedeh T Taheri ◽  
Shayan Alijanpour

Background Stroke is the second leading cause of death worldwide and is associated with several risk factors with variable risk factor distribution by population. We report the types and frequency of the associated factors of stroke in north Iran. Methods Consecutive patients with stroke were recruited from 2014 to 2015. The two groups of ischemic and hemorrhagic stroke were compared with respect to age, sex, the prevalence, and distribution of the risk factors. Results Among 230 patients (84.3% ischemic stroke) with mean age of 61.2 years, hypertension (73%), diabetes mellitus (53%), cardiovascular disease (51%), and dyslipidemia (47%) were the most frequent risk factors. Hypertension was significantly more prevalent in males compared with females (88% vs. 60%, OR = 4.91, 95% CI: 2.48–9.71). Hypertension, smoking, and opioid consumption were associated with hemorrhagic stroke. Dyslipidemia was significantly higher in ischemic stroke (OR = 2.65, 95% CI: 1.21–5.8). Overall, 84.3% of stroke occurred in patients aged >50 years (92.8% of women vs. 74.5% of the men, OR = 4.43, 95% CI: 1.93–10.16, p = 0.001). Conclusion Stroke was more prevalent in females; hypertension was more prevalent in males. In the age group less than 50 years old, stroke is more prevalent in men.


2014 ◽  
Vol 87 (4) ◽  
pp. 242-249 ◽  
Author(s):  
Dana Marieta Fodor ◽  
Ioana Babiciu ◽  
Lacramioara Perju-Dumbrava

Aims and BackgroundThe circadian pattern of stroke occurrence variation has been recognized with certain differences between authors and stroke types. The underlying reason may be related to exogenous factors (cyclic physical activity, including sleep–awake cycles and assuming the up-right posture) and endogenous factors, with their diurnal variation (blood pressure, hemostatic balance, autonomic system activity). The aims of the present study are to investigate the existence of a circadian variation of stroke and the possible differences between stroke subtypes in the Cluj Napoca area.Materials and MethodThe stroke event data were acquired from the Patient Records of a consecutive series of 1083 patients admitted through the Emergency Room at Neurology Departments I and II of the District Hospital of Cluj Napoca, between 1 January 2012 and 31 December 2012. The classifiable onset time was assigned to one of four six-hour intervals: 00.01-06.00 (night), 06.01-12.00 (morning), 12.01-18.00 (afternoon) and 18.01-24.00 (evening). Demographic data and vascular risk factors were recorded.ResultsAll three stroke types (ischemic stroke, hemorrhagic stroke and subarachnoid hemorrhage) have shown a circadian variation regarding their occurrence, with the peak of incidence in the morning and the nadir during nighttime. This circadian pattern is independent by demographic factors and vascular risk factors.ConclusionOur study confirmed the circadian variation of onset occurrence for all stroke subtypes. Some triggering factors promote ischemic stroke and prevent hemorrhagic stroke. The diurnal pattern of variation with the higher incidence in the morning and the lower in the night may lead to chrono-therapeutic and preventive approach (chrono-therapy of the risk factors), which targets the period of the highest vulnerability after awaking.


2013 ◽  
Vol 2 (2) ◽  
pp. 57
Author(s):  
Cintya Agreayu Dinata ◽  
Yuliarni Safrita Safrita ◽  
Susila Sastri

AbstrakStroke merupakan penyakit akibat gangguan peredaran darah otak yang dipengaruhi oleh banyak faktor risiko terdiri dari yang tidak dapat diubah berupa usia dan jenis kelamin dan yang dapat diubah seperti hipertensi, peningkatan kadar gula darah, dislipidemia, dan pekerjaan. Penelitian ini bertujuan untuk mengetahui distribusi tipe stroke dan faktor risiko yang berpengaruh pada pasien stroke rawat inap di RSUD Kabupaten Solok Selatan. Metode penelitian: Penelitian ini adalah penelitian deskriptif dengan menggunakan data skunder pasien stroke yang dirawat di RSUD Solok Selatan. Data yang diambil meliputi usia, jenis kelamin, tekanan darah, kadar gula darah, profil lipid saat pertama pasien masuk rumah sakit, dan pekerjaan. Sampel penelitian adalah seluruh pasien stroke yang pernah dirawat di Bagian Penyakit Dalam RSUD Kabupaten Solok Selatan pada periode 1 Januari 2010 – 31 Juni 2012 yang memenuhi kriteria inklusi. Hasil penelitian: Hasil penelitian menunjukkan proporsi stroke terbanyak adalah stroke ischemic (61,46%), perempuan (54,17%) yang berusia >50 tahun (81,25%) yang bekerja sebagai ibu rumah tangga (43,75%). Faktor risiko yang dapat diubah tertinggi adalah hipertensi (82,30%) diikuti kolesterol total meningkat (69,79%). Faktor risiko tertinggi pada stroke ischemic adalah gula darah meningkat (47,89%) dan pada stroke hemorrhagic adalah hipertensi (100,00%). Faktor risiko tertinggi pada seluruh pasien adalah hipertensi (82,30%). Kesimpulan: Berdasarkan hasil penelitian ini disimpulkan bahwa stroke tipe ischemic lebih banyak dari tipe hemorrhagic dengan faktor risiko utama hipertensi, sedangkan stroke ischemic terutama dipengaruhi oleh peningkatan gula darah.Kata kunci: stroke ischemic, stroke hemorrhagic, faktor risiko strokeAbstractStroke is a disease caused by disorder of brain blood circulation with many risk factors that contribute in this disease, consist of non modifiable risk factor including age and sex and modifiable risk factors example hypertension, high glucose level, dyslipidemia, and jobs. This study aimed to determine the distribution of the type of stroke and the risk factors that affect to stroke patients who were treat in South Solok hospital.Methods: This research is descriptive research using secondary data, including the patient’s medical record. The data including age, gender, blood pressure, glucose level, lipid profile when the first patient in the hospital, and jobs. The samples were all stroke patients who had been treat in the Department of Internal Medicine of South Solok hospital in the period from January 1st 2010 until June 31th 2012 that meet the inclusion criteria.The results: The results showed the highest proportion of strokes were ischemic stroke (61.46%), women (54.17%) aged> 50 years (81.25%) who work as housewives (43.75%). The highest of modifiable risk factors are hypertension (82.30%) followed by increases in total cholesterol (69.79%). The highest risk factors for ischemic stroke is high glucose level (47.89%) and for hemorrhagic stroke is hypertension (100.00%). The highest risk in both ischemic stroke and hemorrhagic is hypertension (82.30%).Conclusion: Based on the end result, we can concluded that the insidence of ischemic stroke disease is greater than hemorrhagic stroke, and as the main risk factor is hypertension, mean while ischemic stroke is most affected by high glucose level.Keywords: stroke ischemic, stroke hemorrhagic, faktor risiko stroke


2016 ◽  
Vol 7 (01) ◽  
pp. 72-76 ◽  
Author(s):  
Lukman Femi Owolabi ◽  
Aliyu Ibrahim ◽  
Ibrahim Musa

ABSTRACT Background: Posterior circulation stroke (PCS), though less common, differs from stroke in anterior circulation in many aspects. Relatively, it portends a poorer prognosis. However, there is a paucity of data from African countries, in particular, where stroke is a menace. Objective: The study aimed to evaluate the etiology, clinical characteristics, outcome, and predictors of outcome in a cohort of patients with IPCS in Northwestern Nigeria. Materials and Methods: Out of 595 patients with stroke, we prospectively analyzed 57 patients with PCS in a Tertiary Care Center in Kano, Northwestern Nigeria. Patients were analyzed for demographic data, risk factors, clinical characteristics, stroke subtypes, mortality, and predictors of mortality. Results: Posterior circulation ischemic stroke accounted for 57 (9.6%) of 595 of all strokes seen in the study period. They comprised 44 males (mean age 47.8 ± 17.7) and 13 females (mean age 46.3 ± 13.7). Overall, their age ranged between 24 and 90 (mean age 47.4 ± 16.7). However, 52.7% of the patients were < 45 years of age. The most common site affected was the cerebellum seen in 33 (57.9%) patients. Hypertension was the most common risk factor (86%). Headache and vertigo were the most common features accounting for 83.6% and 86.3%, respectively. Thirty-eight (66.7%) patients had an ischemic stroke. Twenty-one (36.8%) of the patients died during the 1-month period of follow-up. Independent predictors of death in the study were hyperglycemia on admission and hemorrhagic stroke. Conclusions: IPCS occurred in a relatively younger age group. Headache and vertigo were the most common symptoms. The independent predictors of death in the study were hyperglycemia at presentation and hemorrhagic stroke.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jin-Man Jung ◽  
Hong Ju Shin ◽  
Jae-Young Kim ◽  
Woo-Keun Seo

Objective: To compare incidence of ischemic stroke, hemorrhagic stroke and all-cause mortality in Korean adults congenital heart disease (ACHD) to that of control and scrutinize risk factors for these outcomes. Methods: Subjects aged over 20 were collected from the Korea National Health Insurance Service from 2006 through 2017. ACHD group as case was extracted from the diagnosis records related to CHD according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD 10). Those without CHD (control group) was selected as 4 controls for each patient through random sampling. We compared incidence rate of ischemic stroke, hemorrhagic stroke and all-cause mortality. Cox proportional hazard models were used to investigate relevant risk factors for each of outcomes. Results: Case and control group were 49,445 and 249,649, respectively. Age-adjusted rates of ischemic stroke, hemorrhagic stroke and all-cause mortality in case was by about 4 times more higher than those of control. Cumulative survival plot demonstrated that ACHD was associated with ischemic stroke (HR 1.31 95% CI 1.25-1.36), hemorrhagic stroke (HR 1.49 95% CI 1.36-1.63), and all-cause mortality (HR 1.41 95% CI 1.35-1.46). Case group was associated with younger age, female, hypertension, diabetes mellitus, coronary artery disease, heart failure, atrial fibrillation (all p <.001). In Cox proportional hazard model for ischemic stroke, diabetes (HR 2.13 95% CI 1.93-2.35) and coararctation of aorta (HR 1.54 95% CI 1.13 - 2.09) carried highest risk. In multivariable analysis for hemorrhagic stroke, hypertension (HR 2.28 95% CI 1.74-2.98) was highest risk factor. Multivariable analysis for all-cause mortality showed that congestive heart failure (HR 1.78 95% CI 1.65-1.92) and Eisenmenger syndrome (HR 2.91 95% CI 2.53-3.35) was highest risk factor. Conclusions: Korean ACHD patients have significantly higher incidence of co-morbidities including hypertension, diabetes mellitus, several heart diseases. They have a higher tendency of ischemic, hemorrhagic stroke and mortality. These findings suggest that medical surveillance and risk factor management is sustainedly needed for ACHD patients to reduce stroke and mortality in the future.


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