Abstract
A STUDY OF CLINICAL PROFILE, RISK FACTORS AND DRUG UTILIZATION PATTERN IN CEREBROVASCULAR STROKE

Jaladi Himaja* and Battu Rakesh

ABSTRACT

Background: Stroke continues to be one of the leading causes of mortality and morbidity worldwide. Each year, stroke occurs in 30.9 million individuals worldwide and is responsible for ∼4 million deaths. Stroke is a disease of multifactorial aetiology that may develop as an end state in patients with serious vascular conditions—most notably, uncontrolled arterial hypertension. Apart from death, the greatest burden of stroke is serious long-term physical and mental disability. Stroke has deleterious effects on quality of life. Chronic arterial hypertension is the most significant modifiable risk factor for stroke. Other risk factors include diabetes mellitus, dyslipidaemia, smoking, alcohol consumption, atrial fibrillation. Treatment of elevated blood pressure during acute stroke must balance the theoretical risk of worsening the stroke due to reduced cerebral perfusion against the benefits of lowering blood pressure (reduced risk of haemorrhage, cerebral oedema, and other end-organ damage). Study of risk factors and drug-prescribing pattern can give insight into the trends in using the drugs in cerebrovascular stroke in treating their co-morbid conditions. The knowledge of drug utilization pattern can lead us towards the rational drug use and help to take measures to improve prescribing habits. Risk factors modification remains as the principal aspect of care for stroke prevention. Understanding of risk factors has advanced and several options are now available to treat modifiable risk factors. However, effective treatment remains a challenging task in clinical practice. Objectives: Primary: To study the clinical profile and prevalence of cerebrovascular stroke. Secondary: To evaluate the risk factors and drug utilization pattern in cerebrovascular stroke. Study Design: A Cross Sectional study was carried out in the General Medicine Department, MIMS Teaching Hospital, Mandya, Karnataka, using a well-designed patient proforma. Results: In this study, among 70 cases of cerebrovascular stroke analysed, the incidence of stroke was more common in male n=50 (60.6%) and n=20 (39.4%) were females. In this study 2 types of stroke was identified, 59 Ischemic stroke and 11 haemorrhagic stroke patients. Most of the patients diagnosed with stroke are in age group of 61-70 (38.57%). The most common co-morbid conditions were hypertension 34 (48.57%), diabetes mellitus 8 (11.42%) and a combination of hypertension, diabetes, dyslipidaemia 12 (17.14%) patients. The prescription pattern of various drugs were found to be as – antiplatelet drugs 59 (84.28%), anti-hyperlipidemic drugs 70 (100%), anti-diabetics 38(54.28%) antibiotics 57 (81.42%), anti-anginal drugs 25 (35.71%), antihypertensives 70 (100%), anticoagulants 12 (17.14%), diuretics 45 (64.28%) and bronchodilators 25 (35.71%). The average number of drugs per prescription was found to be 7.55. The most commonly prescribed drug classes in cerebrovascular stroke were anti-hyperlipidemic drugs, anti-hypertensives, antiplatelet drugs. Conclusion: The incidence of stroke was more common in male compared to female. Diabetes Mellitus, Hypertension, Hyperlipidaemia, Smoking and alcohol consumption are the risk factors for developing cerebrovascular stroke. Effective treatment in stroke remains a challenging task in clinical practice. Identifying and modifying key risk factors is crucial to reducing the morbidity and mortality of stroke. Computed tomography remains an appropriate imaging technique in the early assessment of most stroke patients.

Keywords: Cerebrovascular stroke, Arterial Hypertension, Atrial Fibrillation, Dyslipidaemia, Drug Utilization pattern, Computed Tomography.


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