Risk factors for stroke: a hospital based study

Stroke is the commonest neurological cause of morbidity and mortality all over the world being the third leading cause of death. The goal of this study was to ascertain the frequency of risk factors for first ever stroke in our patients. This prospective study included all patients of either sex, 20 to 70 years and above admitted in Dr. Ziauddin Medical University Hospital, North Nazimabad Campus, Karachi, with first ever stroke verified by CT scan brain during a period of one year. Data analysis showed that 70.1% had cerebral infarction and 29.9% cerebral hemorrhage. The mean age at presentation was 62 years and male to female ratio 1.05:1.The most frequent risk factors included hypertension 65.8%, smoking 43%, diabetes mellitus 41.3%, underlying cardiac diseases 29.1%, family history of stroke/transient ischemic attack in the first-degree relatives 26.7%, high cholesterol 25.5%, history of past transient ischemic attack 24.9% and significant extracranial carotid atherosclerosis in 18.18%. In-hospital mortality was 11.7%. At 30-day follow up 22.27% of all stroke survivors were functionally independent. This study suggested that diabetes mellitus was more and underlying cardiac diseases less frequent in our patients than in the western reported series. Cerebral hemorrhage was relatively morecommon and the mean age at presentation was lesser compared to those in the developed countries. Stroke patients consume a large part of health resources all over the world so accurate information about the incidence, risk factors, management and outcome is needed for planning medico-social services besides primary and secondary stroke prevention in the community

Evaluation the outcome of stroke: a prospective hospital based study

This study was aimed to determine the functional outcome after stroke and to assess the influence of various factors on acute in-hospital stroke mortality. This prospective study included 281 stroke patients of either sex, 20 to 70 years and above admitted in Dr. Ziauddin Medical University Hospital, North Nazimabad Campus, Karachi, during a period of one year. Main outcome measures used were Glasgow Coma Scale [GCS] and Modified Rankin Scale [mRS]. Data analysis showed that in-hospital mortality was 11.74% [n=33/281]. Age and gender had no adverse effect on acute mortality in this study while poor initial GCS; hemorrhagic stroke and all the studied risk factors were bad prognostic factors. At the end of one month, 32 patients were lost to follow-up and mortality was 13.5% [n=5/216] while excellent outcome was observed in 22.27% [n=47/216] and poor outcome in 77.72% [n=164/216] of patients. This study confirms the significant morbidity and mortality associated with stroke and shows the need in preventing and controlling the risk factors for early death