Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

Abstract

Background: Stroke is a disabling condition that has physical and mental impact on a patient’s life. Stroke is an important morbidity for low and middle income countries like Nepal. Hypertension, diabetes, smoking, and dyslipidemia are common risk factors in this regard and are inadequately controlled; mainly because of poor public awareness, inadequate infrastructure, lack of service and qualified manpower.Objectives: This study aims to provide insight into the epidemiology and risk factors in ischemic stroke patients.Methodology: A descriptive cross sectional study was conducted in 92 ischemic stroke patients at a tertiary care hospital Kathmandu Medical College and Teaching Hospital (KMCTH), Sinamangal, Nepal from December 2017 to June 2018. Consecutive sampling technique was used and data was collected from ischemic stroke patients above 14 years of age who were admitted in the Department of Neurology. Information regarding pre-morbid and morbid conditions, imaging findings as well as results was obtained from biochemical analysis of blood after taking consent from the patient or patient’s relative. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis.Results: Their mean age was 63.25 years with standard deviation of 16.45. Dyslipidemia was the most commonly found risk factor which was present in 77.2% of the subjects, followed by smoking (59.8%), presence of carotid artery atherosclerosis (59.8%), hypertension (50%), atrial fibrillation (26.1%) and diabetes mellitus(15.2%). Smoking was significant in males and heart disease was mostly seen in females.Conclusion: Dyslipidemia and smoking were the most common risk factors followed by carotid artery atherosclerosis. Patients with hypertension and dyslipidemia had higher incidence of stroke in both young and elderly group.

Dyslipidemia among Patients with Ischemic Stroke in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…This finding was supported by study done in our country which show that dyslipidemia was present in 77.2%. 4 Similarly, a study done in Nigeria showed an incidence of dyslipidemia was 92.30% which is significantly higher as compared to our study. 13 This may support that, a study done in our country states that the high dominance of dyslipidemia could be due to the sedentary lifestyle and environment changes among Nepalese patients and found a three-fold rise in the incidence of dyslipidemia in stroke patients.…”

“… 2 Population aged 60 or over is rising faster than young age group worldwide. 3 , 4 Reports have suggested that about 80% strokes occurred in individuals aged >65 years, among which 50% were aged ≥70 years and nearly 25% aged >85 years. 5 However one third of strokes occur in persons younger than 65 years.…”

Subtypes, Risk Factors and Site of Stenosis of Ischaemic Stroke in a University Hospital in Bangladesh

“…A total of 69.10% of respondents of this study was male, and it showed male predominance than female in ischaemic stroke and almost two-thirds of patients are above the age of 50. Beg et al (2015) found in India that the number of males is greater than that of female, Bhowmik et al (2016) found 67.7% in Bangladesh, Shakya et al (2019) found 51.1% in Nepal. The finding is also similar in developed countries.…”

“…A study done by Cotter et al (2011) found that the mean age was 63.2, and another study of 679 patients done by Bhowmik et al (2016) found the mean age to be 60.4 years. In Nepal, Shakya et al (2019) conducted a study where the mean age was 63.2 years. However, in Europe, Caso et al (2010) found the mean age as 72.68 (±13.27).…”

Vascular Imaging Based Subtyping of Ischemic Stroke in BSMMU

“…A study of 2450 patients done by Bouzidi and associates17 found mean age was 63.2, and another of 679 patients done by Bhowmik NB et al13 found 60.4 years. In Nepal mean age was 63.2 years done by Shakya D and associates14 . However in Europe Caso V et al15 found mean age as 72.68(±13.27).This study finds large artery atherosclerosis (LAA) is the most common sub type as 43.67% (n=385).…”