Clinical Profile of Stroke Patients Presenting to the Emergency Department of a Major Stroke Centre in Oman

Harthi, Hasina Al; Kashmiri, Ammar Al; Zakaryia, Lubna M.; Al-Lawati, Jawad; Najem, Omar M.; Al-Lawati, Isra; Memon, Ghulam R.; Elfaham, Amr A.

doi:10.18295/squmj.4.2021.062

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…The fact that many of our patients had poor blood pressure management caused by non-adherence to treatment due to cost and drug availability certainly increased the significance of hypertension control. As noted in this study, diabetes mellitus ranked second on the list of risk factors as did other hospital studies around the world [7,[17][18][19][20][21][22][23][24][25][26].…”

Section: Vol 1 | Issue 2 | Jul -Dec 2022supporting

confidence: 55%

Risk factors and outcomes of stroke in a tertiary hospital in Hadhramout Governorate, Yemen

Basamed¹

2022

YJM

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Background: Although stroke is a major problem in Hadhramout Governorate, there is a scarcity of reliable information on risk factors of stroke and in-hospital mortality. The aim of this study was to explore the risk factors and outcomes of stroke patients admitted to Ibn Sina hospital, Hadhramout, Yemen, and to identify the predictors of in-hospital mortality. Methods: This retrospective cross-sectional study was conducted in Ibn Sina hospital in al-Mukalla district, Hadhramout Governorate, over a 4-month period (1 January 2021-30 April 2021). Results: During the study period, we recruited 100 cases of stroke, of them, 77 (77%) were males and 23 (23%) females. Their mean age was 65.42±12.78 years. The most frequent risk factor was hypertension 81 (81%), and family history was positive for stroke in 31 (31%) patients and a history of a previous stroke was present in 30 (30%) patients. Risk factors were not identified (Cryptogenic) in 5 (5%) cases. Ischemic stroke was identified in 70 (70%) cases, while hemorrhagic stroke was found in 30 (30%) patients. The in-hospital mortality was 29 (29%), and the univariate analysis found male sex, hypertension, and hemorrhagic stroke as probable predictors of in-hospital mortality. Only hemorrhagic stroke (Adjusted OR= 2.053; 95% CI=0.822-1.599; P<0.001), and hypertension (Adjusted OR= 1.677; 95% CI=0.555-1.495; P=0.011), were found to be independent predictors of mortality by multivariate logistic regression analysis. Conclusion: Stroke is a major problem in Hadhramaut Governorate with ischemic stroke being more than hemorrhagic. Men were more likely to have a stroke than women and the majority of cases were elderly. Hypertension, Diabetes mellitus, smoking, and dyslipidemia were the most commonly identified risk factors that were significantly associated with stroke. Hemorrhagic stroke and the presence of hypertension were found as risk factors for in-hospital mortality, therefore, hypertension should be well-controlled to reduce in-hospital mortality.

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Section: Vol 1 | Issue 2 | Jul -Dec 2022supporting

confidence: 55%

Risk factors and outcomes of stroke in a tertiary hospital in Hadhramout Governorate, Yemen

Basamed¹

2022

YJM

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“…Harthietal. 28 found higher rates of hypertension as the most prevalent risk factor (72.5%) followed by DM (54.4%) when compared with this study, Itagietal. 29 reported hypertension in 38% cases followed by hypertension with diabetes mellitus in 23%.…”

Section: Discussioncontrasting

confidence: 54%

“…Similar male predominance was observed in other studies from Asia when compared with European and North American studies. 28,29 Hypertension was the most common risk factor in all the studies relating to SICH. Feldmann et al have reported a relative risk of 3.9 for ICH in patients with hypertension.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mortality in Spontaneous Intracerebral Hemorrhage Cases

Bongu¹,

Singhal²,

Kumar³

et al. 2022

MRAJ

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Aim and objectives: This study was done with the aim of finding clinical and radiological correlation of patients with spontaneous intracerebral hemorrhage (SICH) and its correlation with 90-day mortality. The primary objective was to study the clinical, laboratory and radiological predictors of mortality in patients of intracerebral hemorrhage. The secondary objective was to compare 90-day mortality in patients with spontaneous intracerebral hemorrhage with that to coagulopathy related intra cerebral hemorrhage. Methods: This was a longitudinal, observational study carried out from June 2020 to June 2022 at Govt hospital situated in North India. The relevant history and clinical examination was done according to pre designed and pretested protocol. All patients underwent non-contrast computerized tomography imaging, their Glasgow coma scale score and intracerebral hemorrhage score were noted. For the sake of coagulopathy related intracerebral hemorrhage, the patients were classified as taking single antiplatelet, dual antiplatelet agents and oral anti-coagulant drugs. These patients were followed up daily during the hospital stay and regularly thereafter until 90 days. Functional outcome of patients was determined by modified Rankin's scale at 30 days and 90 days. The statistical analysis was done using SPSS software. Results: A total of 235 cases were studied. 202 patients were detected to have hypertension, out of which 25 (12.37%) deaths were recorded within 48hrs of admission, 77 (38.1%) and 85 (42%) of patients with hypertension had died at 30 days and 90 days respectively. Similarly, out of 40 diabetics in this cohort, 15 (37.5%) and 18 (45%) deaths occurred at 30 and 90 days. 97 out of 235 cases who consumed alcohol, 56 (57.7%) and 61 (62.9%) died at 30 and 90 days. Among 52 smokers in this study, 21 (40.4%) and 24 (46.2%) died at 30 and 90 days. Death at 30 and 90 days was significantly more among subjects with intracerebral hemorrhage score of 3 or more with P value of 0.001 and also in patients with GCS score less than 8. Higher mortality rates were seen among subjects with modified Rankin's scale (mRS) score 6 with P value of 0.001 at 30 days. Total number of coagulopathy related intracerebral hemorrhage cases were 99/235. On radiological correlation between spontaneous intracerebral hemorrhage and coagulopathy related intracerebral hemorrhage, this study did not find any strong correlation. The P value was 0.913 at 30 days and 0.961 at 90 days. Conclusion: This study found that comorbidities like hypertension and type 2 Diabetes mellitus were significant predictors of mortality in spontaneous intracerebral hemorrhage cases. The significant correlation was also found between consumption of alcohol and smoking with mortality in intracerebral hemorrhage cases. The 30 and 90-day mortality was significantly among subjects with ICH score 3 or more and also in patients with GCS score less than 8. Similarly, higher mortality is seen with higher modified Rankin score at 30 days. On radiological examination, the Intra cerebral bleed volume greater than 30 ml was greatest predictor of death. This study did not find coagulopathy as a strong predictor of mortality when compared with spontaneous modified Rankin score. Similarly, the location of intra cerebral bleed was not associated with higher mortality in this study.

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Global stroke statistics 2023: Availability of reperfusion services around the world

Kim,

Olaiya,

De Silva

et al. 2024

International Journal of Stroke

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Background: Disparities in the availability of reperfusion services for acute ischaemic stroke are considerable globally, and require urgent attention. Contemporary data on the availability of reperfusion services in different countries provide the necessary evidence to prioritise where access to acute stroke treatment is needed. Aims: To provide a snapshot of published literature on the provision of reperfusion services globally, including when facilitated by telemedicine or mobile stroke unit services. Methods: We searched PubMed to identify original papers, published up to January 2023, with the most recent, representative and relevant data for each country. Keywords included thrombolysis and telemedicine. We also screened reference lists of review papers, citation history of papers, and the grey literature. The information is provided as a narrative summary. Results: Of 11,222 potentially eligible papers retrieved, 148 were included for review following de-duplications and full text review. Data were also obtained from national stroke clinical registry reports, Registry of Stroke Care Quality (RES-Q) and Pre-hospital Stroke Treatment Organization (PRESTO) repositories, and other national sources. Overall, we found evidence of the provision of intravenous thrombolysis services in 70 countries (6463% high-income countries (HICs)) and endovascular thrombectomy services in 33 countries (68% HICs), corresponding to far less than half of the countries in the world. Recent data (from 2019 or later) were lacking for 35 of 67 countries with known year of data (52%). We found published data on 74 different stroke telemedicine programs (93% in HICs) and 14 active mobile stroke unit pre-hospital ambulances services (80% in HICs) around the world. Conclusion: Despite remarkable advancements in reperfusion therapies for stroke, it is evident from available data that their availability remains unevenly distributed globally. Contemporary published data on availability of reperfusion services remain scarce, even in HICs, thereby making it difficult to reliably ascertain current gaps in the provision of this vital acute stroke treatment around the world.

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Clinical Profile of Stroke Patients Presenting to the Emergency Department of a Major Stroke Centre in Oman

Cited by 4 publications

References 31 publications

Risk factors and outcomes of stroke in a tertiary hospital in Hadhramout Governorate, Yemen

Risk factors and outcomes of stroke in a tertiary hospital in Hadhramout Governorate, Yemen

Predictors of Mortality in Spontaneous Intracerebral Hemorrhage Cases

Global stroke statistics 2023: Availability of reperfusion services around the world

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