A RETROSPECTIVE STUDY ON EFFECTS OF SERUM CHOLESTEROL ON MORTALITY AND MORBIDITY OF STROKE

Abstract

Introduction:Stroke or cerebrovascular accident or Intracranial Hemorrhage (ICH) is definedas an abrupt onset of a neurological deficit that is attributable to a focal vascularcause. Stroke is the second leading cause of death worldwide causing 6.2million deaths in 2011. Relation of high total cholesterol and triglycerides withischemic heart disease is well established worldwide. High cholesterol level areestimated to cause 56% of ischemic heart disease. However, dyslipidemia as arisk factor for ischemic stroke has been quite controversial in recent times. Ithas been observed in several studies that higher cholesterol and triglyceridelevels are associated with better outcome after ischemic stroke.Aim:The purpose of this study is to determine the effects of serum cholesterol on themortality and morbidity of stroke.Materials and Method:We retrospectively included 100 consecutive patients over age 18 with Strokeor cerebrovascular accident or Intracranial Hemorrhage (ICH) who wereadmitted in Sree Mookambika Institute of Health Sciences, confirmed by CTwithin 12 hours after onset. Patients with traumatism, brain tumor, previousICH, hemorrhagic transformation of ischemic stroke, vascular cerebralmalformations, and patients who required neurosurgical procedures wereexcluded. Data was collected with meticulous history, clinical examination withdetailed neurological examinations along with appropriate investigations. Astructured questionnaire was used to obtain data on family history of diabetes mellitus, history of hypertension, past and present illness, dietary pattern,addiction and medication. NIH stroke scale (NIHSS) were evaluated atadmission. Descriptive and analytical statistics were performed by SPSSversion 16.IEC clearance and a written informed consent were obtained frompatient or patients attenders. A P value of less than 0.05 was consideredstatistical significant.Results:Out of the 100 patients that were included in the study, the average age was 58.6± 12.15. Male to female ratio was 3:1(75:25) which clearly states that men aremore prone to develop stroke compared to females. Among the patients who hadstroke, risk factors like hypercholesterolemia(75%), hypertension(65%),diabetes mellitus(24%), smoking(40%), alcoholism(40%) were identified.Regarding the stroke severity, 39% of the patients had a minor stroke, 44% hada moderate intensity stroke while 17% of the patient had a severe stoke. A highmorbidity rate i.e., 80% was seen in patients who had had high totalcholesterol(75%) then compared to patients who had normal lipid profile with asignificant p value (<0.02).Only 2 passed away who was also found to have highcholesterol and triglycerides.Conclusion:Our study concluded a positive correlation between serum total cholesterol.Thus early detection of dyslipidemia and treatment with drugs along withdietary modifications & lifestyle changes can reduce the risk of stroke.Keywords: ICH, Stroke, Total Cholesterol, Cerebrovascular accident