Abstract
FACTORS ASSOCIATED WITH STROKE AND ITS OUTCOME AMONG PATIENTS ATTENDING TERTIARY CARE HOSPITAL IN BANGALORE

*Aruna Tubachi, Dr. S. Pruthvish, Dr. Dinesh Rajaram, Dr. R. Srinivasa

ABSTRACT

Introduction: Globally, cerebrovascular disease (stroke) is the second leading cause of death. Comprehensive information on stroke mortality, morbidity, risk factors and disability are required for planning and implementing programmes in prevention, management and rehabilitation. Due to demographic changes, strategies to reduce stroke burden and ensure adequate health resources are urgently needed. Objective: To study the factors associated with stroke and its outcome. Material and Methods: Case control approach for assessing risk factors and longitudinal study-follow up of 28 days for assessment of outcome. Pre designed, semi structured questionnaire was administered after validation by pilot testing. Study Population: Cases: All patients with first stroke diagnosed and confirmed with radiological investigations admitted to the hospitals. Controls: For each case two controls were selected (1:2) for whom gender and +5 year age class intervals was matched. Sample Size: Sample size worked out to be 60 cases and 120 controls. Statistical analysis: Frequency of various risk factors among the cases and controls was found out and tested for statistical significance employing chi-square/ Fischer exact test. Significant factors in the univariate analysis was included for multivariate logistic regression analysis to find out the independent risk factors related to the development of the disease. Results: Mean age of persons with stroke was 61.08+1.32. 27(45%) of cases had diabetes. 38 (63.3%) of cases had hypertension. Hypertension and family history were highly statistically significant (p=<0.001). 19(31.7%) of cases were either past or present smokers. 16(26.7%) of cases and 17(14.2%) of controls had history of alcohol intake. Functional outcome of stroke subjects was measured using Modified Rankin Scale at the time of admission and at the end of 28 days. Mean score was 23.95 at the time of admission and 17.95 at the 28 days time. This was statistically not significant (p=0.118). Summary and conclusion: Increasing age, male gender and family history of stroke are the non modifiable risk factors of stroke as seen in this study. Other important modifiable risk factors were diabetes, smoking, alcohol intake, increased central obesity, increased LDL levels which can be reduced using adequate preventive strategies. Severity of the disease is shown by 50% ICU admission, and severe disability in 16.7% of the patients and also by the presence of loss of consciousness and speech impairment and paresis.

Keywords: Stroke, Risk factors, Outcome.


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