Clinical Features, Risk Factors and Hospital Mortality of Acute Stroke Patients

M. Anwar, Sajeda Afrin, A. Mondol, Mohammad Nurul Islam Khan, Narayan Chandra Sarkar, Kamruzzaman Sarkar, Shahed Jahan, M. Rani, R. Mondal
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Abstract

Background: Stroke is a leading cause of mortality and disability worldwide. To prevent complications and permanent defects, early diagnosis, distinguishing the type and risk factor of stroke is crucial. Methodology: It was a hospital based cross sectional study, purposive sampling method was used, and a total of 469 stroke patients admitted into Department of Medicine, Rangpur medical college hospital, Bangladesh were included in this study. Results: In this study we have studied of 469 acute stroke patients. Among them 81% (380) were ischemic stroke patients and 19% (89) were hemorrhagic stroke. Overall male were more than female 308 (65.7%) vs 161(34.4%). The mean age for the ischemic stroke group was 64.1 ± 10.9 years, which was significantly higher than that of the hemorrhagic group (59.8 ± 9.60years) (P<0.05). Acute hemorrhagic stroke patients presented with acute onset of focal neurological deficit 61.8%, headache 64%, vomiting 59.6%, alteration of consciousness 48.3% and convulsion 27%. On the other hand, acute ischemic stroke patient presented with alteration of consciousness 65.5%, acute onset of focal neurological deficit 39.5%, paralysis 41%, deficit after awakening 32.4% and aphasia 34.7%. Among the risk factors of stroke in acute ischemic stroke patients hypertension was 59.2%, diabetes mellitus 20%, history of previous stroke 16.1%, ischemic heart disease 14.5% and atrial fibrillation 10.3% were present, on the other hand in acute hemorrhagic stroke patients hypertension 76.4%, smoking 70.8% and diabetes mellitus 6.7% were present. 26.97% of the acute hemorrhagic stroke and 13.9% of the acute ischemic stroke patients died in hospital. Conclusion: Common presentation of stroke was acute onset of focal neurological deficit; headache and vomiting were more in hemorrhagic stroke patient; alteration of consciousness, paralysis was predominant in ischemic stroke patient.
急性脑卒中患者的临床特征、危险因素及住院死亡率
背景:中风是世界范围内导致死亡和残疾的主要原因。为了预防并发症和永久性缺陷,早期诊断、区分脑卒中的类型和危险因素至关重要。方法:采用医院为基础的横断面研究,采用有目的抽样方法,共纳入孟加拉国Rangpur医学院附属医院内科收治的469例脑卒中患者。结果:对469例急性脑卒中患者进行了研究。其中81%(380例)为缺血性脑卒中,19%(89例)为出血性脑卒中。总体上男性多于女性308人(65.7%)vs 161人(34.4%)。缺血性脑卒中组患者平均年龄为64.1±10.9岁,明显高于出血性脑卒中组(59.8±9.60岁)(P<0.05)。急性出血性卒中患者急性起病表现为局灶性神经功能缺损61.8%,头痛64%,呕吐59.6%,意识改变48.3%,惊厥27%。另一方面,急性缺血性脑卒中患者表现为意识改变65.5%,急性发作局灶性神经功能缺损39.5%,麻痹41%,醒后功能缺损32.4%,失语34.7%。急性缺血性脑卒中危险因素中高血压占59.2%,糖尿病占20%,既往卒中史占16.1%,缺血性心脏病占14.5%,心房颤动占10.3%,急性出血性脑卒中危险因素中高血压占76.4%,吸烟占70.8%,糖尿病占6.7%。26.97%的急性出血性卒中患者和13.9%的急性缺血性卒中患者在医院死亡。结论:卒中的常见表现为急性发作局灶性神经功能缺损;出血性卒中患者头痛、呕吐较多;缺血性脑卒中患者以意识改变、麻痹为主。
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