Clinicodemographic Profile Of Recurrent Stroke And Secondary Prevention At Tertiary Care Centre Of North-West India

Abstract

Background and Aims: Stroke is a major public health problem worldwide. The risk of recurrence is highest in the first year after the stroke, majority of the recurrent cases are due to atherosclerosis of the large arteries. The present study was conducted to evaluate clinico-bio-demographic profile of recurrent stroke patient in respect of risk factor and secondary prevention of stroke. Methods: A hospital-based cross-sectional study was conducted on 300 recurrent ischemic/hemorrhagic stroke (age 18-85 yrs.) from August 2015 to March 2017. Stroke mimic were excluded. Risk factors studied were hypertension, diabetes mellitus, hyperlipidemia, cardiac causes and cigarette smoking. Results: Mean age of recurrent stroke was 60±13 years with male preponderance (M: F=5.3). Ischemic stroke was found in 93% cases. About one third (33%) patients had their first recurrence within three months of index stroke. Active smoking, uncontrolled hypertension and diabetes were found in 71%, 62%, and 65 % cases respectively. There was association between first ever stroke and recurrence showing P value > .05, <.001 and <.01 for uncontrolled hypertension, diabetes and active smoking respectively. Extra cranial stenosis (>70%) was found in 29% of recurrent stroke. Out of all stroke cases 40% were drug defaulters. Conclusions: In our study commonest cause of recurrent stroke was active smoking followed by uncontrolled diabetes, uncontrolled hypertension, poor drug compliance and symptomatic carotid stenosis. Frequency of recurrence was more within 3 months.