Location
Lecture Hall-3
Start Date
27-2-2014 10:15 AM
COinS
Feb 27th, 10:15 AM
Feb 27th, 10:25 AM
Ischemic Strokes in Pakistan: Observations from the National Acute Ischemic Stroke database
Lecture Hall-3
Description
Background: The objective of this study was to establish a multicentre ischemic stroke registry, first of its kind in Pakistan, in order to provide insight into the epidemiology, subtypes and risk factors of ischemic strokes in this country. Methods: Four academic centers (three urban and one rural) participated in this project. The inclusion criteria for subjects included adults (>14years), with acute neurological deficit consistent with clinical diagnosis of ischemic stroke and supported by neuroimaging.
Results:Data was available for 874 subjects. Mean age of the subjects was 59.7 years, 60.5% were males and 18% were young. Large vessel strokes were the commonest subtype found in 31.7% followed by small vessel disease (25.7%) and cardioembolic strokes (10.4%). Almost 32% subjects had ill-defined etiology for their ischemic stroke. Dyslipidemia was most common risk factor present in 83% patients. Data related to in-hospital complications was available for 808 subjects out of which 233 complications were recorded. Pneumonia was the commonest of these, seen in 105 (13%) subjects, followed by urinary tract infection (7.2%).Outcome at discharge was recorded for 697 subjects. 92 had died during hospital stay (13.2%). Only 36% subjects had a favorable outcome at discharge defined as a mRS of 2 or less. A total of 446 subjects out of 697 had poor outcome at discharge (defined as mRS>3). Conclusion: Hypertension and dyslipidemia were the commonest risk factors and large vessel atherosclerosis was the commonest stroke etiology. Elderly patients were significantly more likely to have in-hospital complications, to die during hospital stay and to have a higher modified Rankin score at discharge.
Keywords: Stroke, south Asia, outcome, ischemic