Prevalence and prognosis of cerebrovascular accidents and its subtypes: A cross-sectional study in Hail region, Saudi Arabia

Abstract

Stroke is a major cerebrovascular disease resulting in high mortality and persistent disability in adults across the world. Besides coronary heart disease and cancer, stroke is the commonest cause of death in most industrialized countries [1]. Cerebrovascular accidents (CVAs) are the fifth leading cause of mortality and the leading cause of serious, long-term disability in the United States. Most strokes (87%) are ischemic, caused by thrombotic or embolic occlusion of a major artery [2]. CVA has traditionally been divided into infarcts (embolic or thrombotic) and hemorrhagic lesions based on the pathologic and radiographic appearance. Infarcts are further subdivided into lacunar and cerebral infarcts. Similarly, hemorrhagic lesions are subdivided into intracerebral hemorrhage and subarachnoid hemorrhage (SAH). CVA or stroke occurs when blood flow to a part of the brain is prevented due to blockage, or rupture of blood vessels [3]. Recent statistics on European cardiovascular diseases indicate that stroke is responsible for 4 million deaths, with over 1.9 million deaths recorded in the European Union [4]. In 75% of the Cerebrovascular accidents or stroke is an important healthcare concern. Ischemic stroke is an acute neurologic deficit that results from focal cerebral ischemia leading to permanent tissue damage (infarction). The cause is commonly associated with atherothrombotic occlusion of large arteries, cerebral embolism (embolic infarction), non-thrombotic occlusion of small, deep cerebral arteries (lacunar infarction), and proximal arterial stenosis with hypotension that decreases cerebral blood flow in arterial watershed zones (hemodynamic stroke). Stroke is being observed as a rapidly growing problem and an important cause of illness and death in Saudi Arabia. The aims of this cross-sectional study were to establish the prevalence and prognosis of cerebrovascular accidents and its subtypes in Hail Region, Saudi Arabia. Data were collected on all patients who experienced CVAs between September 2017-January 2018, used the diagnosis coding program in King Khalid Hospital in Hail, Saudi Arabia. Out of 190 patients 63.7% were male and 36.3% were female. The overall incidence of ischemic stroke after acute myocardial infarction was 85.26%. Hypertension, diabetes mellitus were shows as more risk factors for ischemic stroke type compared with hemorrhagic stroke, and embolic stroke. The overall status of stroke patients were shown 92.1% live and 7.9% were dead. Incidence of complicating hospitalizations with cerebrovascular accident continues to grow and is associated with increased mortality and adverse discharge. This highlights the need for early diagnosis, better risk stratification, and preparedness for need for complex long-term care in this vulnerable population.