scholarly journals Study of Risk Factors of Stroke in Patients Admitted at Kohalpur Teaching Hospital

2018 ◽  
Vol 14 (2) ◽  
pp. 53-55
Author(s):  
Sanjib Kumar Shah ◽  
Sunil Shah ◽  
Sujeet Kumar Shah ◽  
Shyam B.K.
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Retrospective Study ◽  
Teaching Hospital ◽  
Hemorrhagic Stroke ◽  
Early Recognition ◽  
Modifiable Risk Factors ◽  
Public Health Burden ◽  
Medical College ◽  
Conventional Risk Factors

 Background: Stroke is the major public health burden and the second major cause of death worldwide. This disease is common in old age persons, however the disease can also be seen in young persons. Identifying the modifiable risk factors of stroke may have contribution in prevention.Objective: The retrospective study was done to study risk factors of stroke in adult patients.Method and Material: This is a hospital based retrospective study conducted in Department of Medicine, Nepalgunj Medical College and st th Teaching Hospital, Kohalpur from the period of 1 January 2015 to 30 October 2016. A total of 119 patients were involved in this study. The diagnosis was confirmed using CT scan after taking history and performing clinical examination. Patients were then evaluated for the presence of both non-modifiable as well as modifiable risk factors. The data analysis was done using SPSS 13.0.Results: The mean age of the patient was 59.76±11.22. Among the collected patients, the higher percentage were male in comparison to female. Ischemic Stroke was more common than hemorrhagic stroke in our study. Other conventional risk factors were as follows: Alcohol use75(63%),cigarette smoking 70(58.8%), hypertension 60 (50.4%),diabetes 11(9.2%),previous vascular event 9(7.6%), heart disease 4(3.4%).Conclusions: Ischemic stroke was more common than hemorrhagic stroke; with alcohol use followed by smoking, hypertension and diabetes mellitus being the most common modifiable risk factors. Incidence of stroke increases with the age and the early recognition and management of the risk factors might reduce this major public burden. JNGMC,  Vol. 14 No. 2 December 2016, Page: 53-55

scholarly journals Changing Epidemiology of Stroke in Nepalese Population

2018 ◽  
Vol 15 (1) ◽  
pp. 10-18
Author(s):  
Amit Thapa ◽  
Bidur KC ◽  
Bikram Shakya ◽  
Dipesh Kumar Yadav ◽  
Karjome Lama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Teaching Hospital ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Vegetative State ◽  
College Teaching ◽  
Diabetic Patients ◽  
Medical College ◽  
First Time

Corrigendum:The article published in Nepal Journal of Neurosciences 2018;15:10-18 by Amit Thapa et al was mistakenlypublished with wrong affi liation of some of the co-authors. The correct affi liation of the co-authors should read asBikram Shakya, MBBS, MS, MChLecturerDepartment of Neurological SurgeryKathmandu Medical College Teaching Hospital (KMCTH)Sinamangal, Kathmandu, NepalDipesh Kumar Yadav, MBBSMedical OfficerDepartment of Neurological SurgeryKathmandu Medical College Teaching Hospital (KMCTH)Sinamangal, Kathmandu, NepalKarjome Lama, MBBSMedical OfficerDepartment of Neurological SurgeryKathmandu Medical College Teaching Hospital (KMCTH)Sinamangal, Kathmandu, Nepal Abstract: We are witnessing changing patterns in stroke in our practice. Documenting changes in epidemiological profile are important for public health policy. We hereby present analysis of patients with stroke to stress upon the dynamics and update the improvement in their care. We retrospectively studied all patients with first time stroke presenting in Kathmandu Medical College Teaching Hospital during June 2012 till November 2015. Diagnosis was made on clinico-radiological basis with prospective follow up for at least 1 year from the event. Risk factors as well outcome in terms of Glasgow outcome score were studied. Statistical analysis was performed on SPSS. A total of 1017 patients of 16260 patients admitted to the hospital during the study period had first time stroke, a hospital based annual incidence of stroke of 64 per thousand admissions was hence calculated. Mean age was 55 years with 60.5% males. 503 patients (49.5%) had infarction with 20 patients having hemorrhagic conversion while 3 had TIA. 50.2% had hemorrhagic stroke. 56.7% females had ischemic stroke whereas 54.9% of males had hemorrhagic stroke (p=0.002). Common risk factors like HTN (54.7%), Smoking (41.5%), Alcohol (39.2%), dyslipidemia (34.1%) and DM (4.8%) were seen with stroke however, active smoker were more at risk of hemorrhagic stroke (p=0.000) while diabetic patients for ischemic stroke (p=0.000). Due to availability of neurosurgical services, 14.6% patient could undergo procedures like decompressive craniectomy, hematoma evacuation, CSF diversion procedures and carotid endarterectomy for stroke. 66.9% patients required surgical intervention within 48 hours of admission. We had 30 days mortality of 0.5% mortality in this series (majority in hemorrhagic stroke), however over 3 years duration of study mortality rose to 8.3% (majority in ischemic stroke). Almost 88.5% patients achieved mRS< Nepal Journal of Neuroscience, Volume 15, Number 1, 2018 11 2 over a period of 3 years. Persistent vegetative state was seen in 7.6% cases after 1 year. We observe a very high incidence of hemorrhagic stroke in general with higher than reported proportion of females being involved with ischemic stroke in our series. Most of the vegetative state conditions occurred in ischemic stroke patients however early mortality was common in hemorrhagic stroke. This change in pattern of stroke as well as need of surgical intervention mandates early involvement of neurosurgical services. Poor long term prognosis in ischemic stroke may be reversed by timely thrombolytic services and prevented by mitigating risk factors. Nepal Journal of Neuroscience 15:10-18, 2018

scholarly journals Gambaran Faktor Risiko dan Tipe Stroke pada Pasien Rawat Inap di Bagian Penyakit Dalam RSUD Kabupaten Solok Selatan Periode 1 Januari 2010 - 31 Juni 2012

2013 ◽  
Vol 2 (2) ◽  
pp. 57
Author(s):  
Cintya Agreayu Dinata ◽  
Yuliarni Safrita Safrita ◽  
Susila Sastri
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Glucose Level ◽  
High Glucose ◽  
Hemorrhagic Stroke ◽  
Secondary Data ◽  
Modifiable Risk Factors ◽  
Stroke Patients ◽  
High Glucose Level

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

scholarly journals Clinical study of acute stroke with special reference to Greek stroke scoring system

2017 ◽  
Vol 5 (3) ◽  
pp. 927
Author(s):  
Sachin Saini ◽  
Harpreet Singh ◽  
Tarsem Pal Singh
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Ct Scan ◽  
Low Income ◽  
Predictive Value ◽  
Scoring System ◽  
Hemorrhagic Stroke ◽  
Modifiable Risk Factors ◽  
Cerebrovascular Event

Background: Stroke is becoming an important cause of premature death and disability in low-income and middle-income countries like India, largely driven by demographic changes and enhanced by the increasing prevalence of the key modifiable risk factors. Rapid access to CT is virtually impossible for all patients with a cerebrovascular event especially in resource poor countries like ours. Aims and objectives of the study were to study the clinical characteristics of patients suffering from acute stroke and to study the efficacy of Greek stroke scoring system in differentiating acute intracerebral infarction and hemorrhagic strokeMethods: Present study was carried out in 50 consecutive patients of stroke admitted to department of Medicine, Guru Nanak Dev Hospital (attached to Government Medical College), Amritsar, Punjab, India. It was a prospective, observational, hospital based study.Results: Maximum number of stroke patients i.e. 36% were in the age group of 61-70 years. Mean±sd age for ischemic and hemorrhagic stroke was 67.9±11 and 57±9 years respectively. 36 patients (72%) had ischemic stroke and hemorrhagic stroke was seen in 14 patients (28%). Among the modifiable risk factors of stroke-hypertension was the most common (68% cases) followed by dyslipidemia (64%), DM (30%), chronic alcohol intake (28%). In the present study, Greek score had a high sensitivity (97%) and positive predictive value (97%) in diagnosing ischemic stroke. It also had excellent specificity (97%) and negative predictive value (97%) in diagnosing hemorrhagic strokeConclusions: Targeting the risk factors for preventing stroke in the first place will help in reducing burden of this often-disabling disease. The CT scan remains as a gold standard in differential diagnosis of stroke and Greek scoring system may be used as a guide in management only when resources are limited and CT scan facilities are not available.

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

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 ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

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.

scholarly journals Association of ADH1B polymorphism and alcohol consumption with increased risk of intracerebral hemorrhagic stroke

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Hsiang Lin ◽  
Oswald Ndi Nfor ◽  
Chien-Chang Ho ◽  
Shu-Yi Hsu ◽  
Disline Manli Tantoh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Genetic Variants ◽  
Regression Models ◽  
Hemorrhagic Stroke ◽  
Alcohol Exposure ◽  
Modifiable Risk Factors ◽  
Aldehyde Dehydrogenase 2 ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background Alcohol consumption is one of the modifiable risk factors for intracerebral hemorrhage, which accounts for approximately 10–20% of all strokes worldwide. We evaluated the association of stroke with genetic polymorphisms in the alcohol metabolizing genes, alcohol dehydrogenase 1B (ADH1B, rs1229984) and aldehyde dehydrogenase 2 (ALDH2, rs671) genes based on alcohol consumption. Methods Data were available for 19,500 Taiwan Biobank (TWB) participants. We used logistic regression models to test for associations between genetic variants and stroke. Overall, there were 890 individuals with ischemic stroke, 70 with hemorrhagic stroke, and 16,837 control individuals. Participants with ischemic but not hemorrhagic stroke were older than their control individuals (mean  ±  SE, 58.47 ± 8.17 vs. 48.33 ± 10.90 years, p  <  0.0001). ALDH2 rs671 was not associated with either hemorrhagic or ischemic stroke among alcohol drinkers. However, the risk of developing hemorrhagic stroke was significantly higher among ADH1B rs1229984 TC  +  CC individuals who drank alcohol (odds ratio (OR), 4.85; 95% confidence interval (CI) 1.92–12.21). We found that the test for interaction was significant for alcohol exposure and rs1229984 genotypes (p for interaction  =  0.016). Stratification by alcohol exposure and ADH1B rs1229984 genotypes showed that the risk of developing hemorrhagic stroke remained significantly higher among alcohol drinkers with TC  +  CC genotype relative to those with the TT genotype (OR, 4.43, 95% CI 1.19–16.52). Conclusions Our study suggests that the ADH1B rs1229984 TC  +  CC genotype and alcohol exposure of at least 150 ml/week may increase the risk of developing hemorrhagic stroke among Taiwanese adults.

scholarly journals Modifiable and Non-Modifiable Risk Factors for Atherothrombotic Ischemic Stroke among Subjects in the Malmö Diet and Cancer Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1952
Author(s):  
Anna Johansson ◽  
Isabel Drake ◽  
Gunnar Engström ◽  
Stefan Acosta
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Family History ◽  
Diet Quality ◽  
Alcohol Intake ◽  
Modifiable Risk Factors ◽  
History Of ◽  
Diet And Cancer

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

scholarly journals "EMMA Study: a Brazilian community-based cohort study of stroke mortality and morbidity"

2016 ◽  
Vol 134 (6) ◽  
pp. 543-554 ◽  
Author(s):  
Alessandra Carvalho Goulart ◽  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Local Community ◽  
Hospital Setting ◽  
Public Healthcare ◽  
Stroke Mortality ◽  
Community Based ◽  
Mortality And Morbidity ◽  
Risk Of Death

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.

Characteristics of Pediatric Stroke and Association of Delayed Diagnosis with Mortality in a Mexican Tertiary Care Hospital

2021 ◽  
Author(s):  
Gerardo Garza-Alatorre ◽  
Ana Luisa Carrion-Garcia ◽  
Alfredo Falcon-Delgado ◽  
Elda Carolina Garza-Davila ◽  
Angel R Martinez-Ponce de Leon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Early Recognition ◽  
Tertiary Care ◽  
Delayed Diagnosis ◽  
University Hospital ◽  
Pediatric Stroke ◽  
Care Hospital ◽  
Continuous Increase ◽  
Common Risk Factors

Abstract Background and objectives Pediatric cerebrovascular disease carries significant morbidity and mortality. Early recognition of a pediatric stroke as well and its most common risk factors are important, but that diagnosis is often delayed. It is believed that the incidence in our center is higher than it appears. This study aims to assess the incidence and characteristics of the pediatric stroke in our university hospital. Likewise, this study seeks to evaluate if a longer symptoms-to-diagnosis time is associated with mortality in patients with ischemic stroke. Methods A retrospective study including children with stroke admitted to the UANL University Hospital from January 2013 to December 2016. Results A total of 41 patients and 46 stroke episodes were admitted. About 45.7% had an ischemic stroke and 54.3% had a hemorrhagic stroke. A mortality of 24.4% and a morbidity of 60.9% were recorded. Regarding ischemic and hemorrhagic stroke, an increased symptoms-to-diagnosis time and a higher mortality were obtained with a relative risk of 2.667 (95% confidence interval [CI]: 1.09–6.524, p = 0.013) and 8.0 (95% CI: 2.18–29.24, p = < 0.0001), respectively. A continuous increase in the incidence rate, ranging from 4.57 to 13.21 per 1,000 admissions comparing the first period (2013) versus the last period (2016), p = 0.02, was found in our center. Conclusions Pediatric stroke is a rare disease; however, its incidence shows a continuous increase. More awareness toward pediatric stroke is needed.

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