A RETROSPECTIVE STUDY OF RISK FACTORS, CLINICAL AND RADIOLOGICAL PROFILE OF STROKE PATIENTS IN SOUTHERN KASHMIR, INDIA

Abstract

Background and Purpose:Stroke is a devastating and major disabling disease affecting 15 million people worldwide per year and causing 6 million deaths annually (the third leading cause of death after cardiovascular and cancer disease). One in six people worldwide suffers from a stroke in their lifetime.This study aims to find the clinical profile, risk factors, and radiological profile of stroke patients in Southern Kashmir of India. Which will be beneficial for taking various preventive measures and planning treatment protocols for stroke patients in the future. Methods:This is a retrospective observational study carried out in south Kashmirfrom August 2016 to February 2020. Stroke was diagnosed clinically and confirmed by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) and Lumbar Puncture (wherever needed). Results:There were 1632 stroke patients (males 64.82% and females 35.18%) in the age group of 24-85 years. A large number of stroke patients (30.39%)were in the age group of 51 to 65 years. The most common presentation of these stroke patients was hemiplegia (64.58%),dysarthria (55.84%), and altered sensorium(30.14%). The dominant risk factors observed were hypertension (69.54%), smoking (65.93%), and dyslipidemia (23.48%). The most common type of stroke was hemorrhagic stroke (67.27%) whereas ischemic stroke and subarachnoid hemorrhage were observed in 28.55% and4.16% of patients respectively. The most common site of hemorrhage in hemorrhagic strokewas at basal ganglion (44.34%) whereas the parietotemporal areawas the most common affected area in ischemic stroke(40.18%). Conclusions:Hemorrhagic strokes are more common in Kashmir because of peculiar social, environmental, and unique food habits causing hypertension and dyslipidemia.In addition, environmental pollution especially during winters also contributes to this type of stroke.The younger generation is becoming increasingly vulnerable to strokes because of extreme stress conditions due to turmoil and unemployment.Furthermore, a sedentary lifestyle, increased use of junk foods, and lack of exercise in winter also add to the risk for stroke. Hemorrhagic and ischemic strokes were more common in maleswhereassubarachnoid hemorrhages are more common in females. Hospital mortality is higher in males in all three types of strokes. Higher hospital mortality in all strokes was associated withmultiple risk factors and an ICH score of 4 or 5.