Abstract
Background: Stroke having two major types, is a clinical presentation which presents loss of brain function; risk factors & complications may vary and which ultimately can lead to death Objective: To determine stroke outcome and its association with factors and complications. Methods: Observational cross-sectional study, conducted from Nov 2015 to Aug 2016 at DHQ Teaching Hospital, KMU Institute of Medical Sciences, Kohat. A pre-designed questionnaire was adopted for data extraction. SPSS 25.0 was used; descriptive and inferential statistics were applied where needed Results: From 100 patients, male were 54% with mean age of 67.48±13.77 years, having 88% Ischemic stroke patients. Hypertension (79%) and family history (39%) were major risk factors while constipation (59%) and aspiration pneumonia (44%) were major complications with in-hospital mortality of 10%. The factors had a higher Prevalence Ratio (PR) for drug abuse (1.330), hypercholesterolemia (1.166), and hypertension (1.036) in ischemic stroke, while in hemorrhagic stroke PR was high for family history (1.918), heart diseases (1.173) and sedentary lifestyle (1.030). In complication, ischemic stroke had a higher PR for constipation (0.996), while hemorrhagic stroke had a higher PR for bed sores (3.286). The results shows an overall mortality of 10% only. Conclusion: The study concluded in-hospital mortality with ischemic stroke more common then hemorrhagic stroke. Hypertension and constipation were a prevalent risk factor and complication respectively. Family history, heart diseases, sedentary lifestyle and all complications were associated more with the hemorrhagic stroke while all other risk factors and no complications had a higher association with ischemic stroke.
Highlights
Stroke is one of the clinical syndrome having symptoms/signs of focal loss of brain function, the symptoms may last for more than 1 day or may lead to death with only apparent cause of vascular origin[1-2]
Where male gender has an ischemic stroke in 90.7% & hemorrhagic stroke in 9.3% while the female gender has 84.8% ischemic stroke and 15.2% has a hemorrhagic stroke
The study evaluated the strength of association for risk factors in ischemic stroke patients as well, where drug abuse was found to be among common risk factor for hemorrhagic stroke with a Prevalence Ratio (PR) of 1.330, this result is against many studies conducted which shows dyslipidemia as one of the most common risk factor for ischemic stroke with an association of 2.503.20 This study reported the decrease strength of PR for hypercholesterolemia (1.166) as reported in literature but it is again an important risk factor for ischemic stroke
Summary
Stroke is one of the clinical syndrome having symptoms/signs of focal (sometimes global) loss of brain function, the symptoms may last for more than 1 day or may lead to death with only apparent cause of vascular origin[1-2]. As per World Health Organization report 2002 total mortality rate in Pakistan due to stroke was 78512, which by 2020 is expected to rise double mainly due to increase in the proportion of older people and current smoking patterns in developing countries like ours[3-4]. It is a worldwide number one cause of disability and number 3 cause of mortality and morbidity in US5-6. Majority surviving the initial damage is mostly dependent due to some level of neurological deficit which depends upon age, size, location of the lesion and previous history of stroke, etc of which mass of initial deficit with recovery is an important parameter for dependence[7]
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