An Analysis of the Risk Factors and the Outcomes of Cerebrovascular Diseases in Northern India 127-131
Dr. Malini Kulshrestha,
Assistant Professor Department of Medicine,
Rohilkhand Medical College, Pilibhit Bypass
Road, Bareilly, U.P. Pin-243006, India.
Introduction: Stroke is a growing epidemic in the developing countries. The risk factors of stroke are the same as those of atherosclerosis, but the relative incidences of the various risk factors keep changing with time and cultural and environmental factors. So, a periodic analysis should be done.
Aims and Objective: The generation of the data which pertained to the clinical profile of stroke in our institution by using the WHO Steps Stroke Manual, version 2 and to make note of the risk factors and the correlation of the outcome with the Glasgowâ€™s Coma Scale (GCS) at admission and with the Modified Rankin Scale (MRS) on the 28th day.
Material and Methods: A prospective study was conducted on 157 cases of stroke patients who were admitted to the Medicine Department of a tertiary care institute during June 2011 through June 2012.
Observations: Amongst the 157 cases (92 males and 65 females), 86 % were above 40 years of age and this was the most prevalent age group in the age range of 51-60 years. The risk factor analysis showed hypertension as the most prevalent risk factor, followed by diabetes cum hypertension. Hemiplegia/hemi paresis was the most common presentation, followed by aphasia. Radiological studies showed that ischaemic strokes were the most frequent ones, followed by haemorrhagic strokes (71 vs. 29 %). Amongst the ischaemic infarcts, the anterior circulation infarct was the most frequent one. The outcome was poor with haemorrhagic strokes and in those who were presented with a GCS of less than 3. The overall mortality was 22.29 %. A significant residual deficit (MRS >3) was seen in 49.7 % of the patients.
Conclusions: There is a need for prospective representative population based surveys viz. the WHO Stroke Steps 2 and 3.Public health measures are essential to enhance the awareness about the importance of knowing the risk factors. Hence, the message which has to be percolated to the masses is - stroke is a â€˜brain attackâ€™ that is preventable.