EVALUATION OF RISK FACTORS AND THEIR PROGNOSTIC VALUE IN PATIENTS WITH ISCHEMIC STROKE

Authors

  • CHANDRA SHEKAR K Department of Medicine, Government Medical College, Machilipatnam, Andhra Pradesh, India.
  • HIMA SREE POLISETTI Department of Pharmacology, A. U. College of Pharmaceutical Sciences, Andhra University, Visakhapatnam, Andhra Pradesh, India. https://orcid.org/0009-0003-6269-7106
  • KARTHIKEYA K Department of Cardiology, NIMS, Hyderabad, Telangana, India.
  • VINAY RAJAN KR Department of Pharmacology, A. U. College of Pharmaceutical Sciences, Andhra University, Visakhapatnam, Andhra Pradesh, India. https://orcid.org/0000-0003-2058-8844

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i11.48012

Keywords:

Ischemic stroke, Hypertension, Risk Factors, NIHSS Score, Barthel Index

Abstract

Objectives: The objectives of this study were to evaluate the risk factors in patients with ischemic stroke, to find out the prognosis of ischemic stroke regarding risk factors, and to identify the patients having modifiable risk factors so that care can be taken to prevent recurrences.

Methods: This was a prospective and observational study with 100 patients with ischemic stroke. Patients were recruited from November 2017 to October 2018. NIHSS score was used to classify the severity of the stroke. The Barthel index was used to assess prognosis at the time of discharge.

Results: The mean age of the study population was 61.4±13.7 years. There was no statistically significant (p=0.28) difference in the outcome of the patients with respect to gender. There was a statistically significant (p=0.04) difference in the severity of the patients respective to gender. Among 100 patients, 55 had hypertension and the relative risk of hypertension was found to be 1.22, indicating hypertension is the most predominant risk factor.

Conclusion: Hypertension is the most prevalent risk factor in the present study. As per our study findings, hypertension, diabetes mellitus, a history of smoking, and a history of alcohol intake were the preventable risk factors, leading to severe stroke and poor functional outcome. Patients with multiple risk factors had severe stroke and poor functional outcome when compared to patients with single or no risk factors. Patients with severe stroke based on NIHSS score had the poor functional outcome.

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References

Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association/ American Stroke Association. Stroke 2013;44:2064-89. doi: 10.1161/ STR.0b013e318296aeca, PMID 23652265

Kasper D, Fauci A, Hauser SL, Longo D. Harrison Principles of Internal Medicine. Vol. 2. New York: McGraw Hill Education; 2015. p. 2879-89.

Pandian JD, Sudhan P. Stroke epidemiology and stroke care services in India. J Stroke 2013;15:128-34. doi: 10.5853/jos.2013.15.3.128, PMID 24396806

World Stroke Organization. Glob Stroke Fact Sheet Slides. USA: World Stroke Organization; 2022.

Mukhopadhyay A, Sundar U, Adwani S, Pandit D. Prevalence of stroke and post-stroke cognitive impairment in the elderly in Dharavi, Mumbai. J Assoc Physicians India 2012;60:29-32. PMID 23777022

Sorganvi V, Kulkarni MS, Kadeli D, Atharga S. Risk factors for stroke: A case control study. Int J Curr Res Rev 2014;6:46.

Romero JR, Morris J, Pikula A. Stroke prevention: Modifying risk factors. Ther Adv Cardiovasc Dis 2008;2:287-303. doi:10.1177/1753944708093847, PMID 19124428

Davis SM, Donnan GA. Clinical practice. Secondary prevention after ischemic stroke or transient ischemic attack. N Engl J Med 2012;366:1914-22. doi: 10.1056/NEJMcp1107281, PMID 22591297

Adams HP, Hachinski V, Norris JW. Ischemic Cerebrovascular Disease. Oxford, UK: Oxford University Press; 2001. p. 575.

Biswas M, Sen S, Simmons J. Etiology and risk factors of ischemic stroke in Indian-American patients from a hospital-based registry in New Jersey, USA. Neurol Asia 2009;14:81-6.

Sylaja PN, Pandian JD, Kaul S, Srivastava MV, Khurana D, Schwamm LH, et al. Ischemic stroke profile, risk factors, and outcomes in India: the Indo-US collaborative stroke project. Stroke 2018;49:219- 22. doi: 10.1161/STROKEAHA.117.018700, PMID 29167386

Irie F, Kamouchi M, Hata J, Matsuo R, Wakisaka Y, Kuroda J, et al. Sex differences in short-term outcomes after acute ischemic stroke: The Fukuoka stroke registry. Stroke 2015;46:471-6. doi: 10.1161/ STROKEAHA.114.006739, PMID 25550372

Kevin Barrett M, Brott TG, Brown RD, Frankel MR, Worrall BB, Silliman SL, et al. Sex differences in stroke severity, symptoms, and deficits after first-ever ischemic stroke. J Stroke Cerebrovasc Dis 2007;16:34-9.

Fahimfar N, Khalili D, Mohebi R, Azizi F, Hadaegh F. Risk factors for ischemic stroke; results from 9 years of follow-up in a population-based cohort of Iran. BMC Neurol 2012;12:117. doi: 10.1186/1471-2377-12- 117, PMID 23031547

Wei W, Li S, San F, Zhang S, Shen Q, Guo J et al. Retrospective analysis of prognosis and risk factors of patients with stroke by TOAST. Medicine 2018;97:e0412. doi: 10.1097/MD.0000000000010412, PMID 29642209

González Hernández A, Fabre Pi O, López Fernández JC, Platero Román M, Cabrera Hidalgo A, Mendoza Grimón MD. Risk factors, etiology and prognosis in patients older than 80 years old with ischemic stroke. Rev Esp Geriatr Gerontol 2008;43:366-9. Available from: https://pubmed.ncbi.nlm.nih.gov/19080953/

Renjen PN, Beg MA, Ahmad K. Epidemiological study of incidence and risk factors of ischemic stroke subtypes according to Trial of ORG 10172 in acute stroke treatment criteria: A 3 years, hospital-based study. Int J Med Public Health 2015;5:50-4.

Dalal PM. Burden of stroke--Indian perspective. J Assoc Physicians India 2004;52:695-6. doi: 10.1111/j.1747-4949.2006.00051.x, PMID 15839444

Nayak AR, Badar SR, Lande N, Kawle AP, Kabra DP, Chandak NH,et al. Prediction of outcome in diabetic acute ischemic stroke patients: A hospital-based pilot study report. Ann Neurosci 2016;23:199-208. doi: 10.1159/000449480, PMID 27780987

Lee JH, Lee JY, Ahn SH, Jang MU, Oh MS, Kim CH, et al. Smoking is not a good prognostic factor following first-ever acute ischemic stroke. J Stroke 2015;17:177-91. doi: 10.5853/jos.2015.17.2.177, PMID 26060805

Ovbiagele B, Weir CJ, Saver JL, Muir KW, Lees KR, IMAGES Investigators. Effect of smoking status on outcome after acute ischemic stroke. Cerebrovasc Dis 2006;21:260-5. doi: 10.1159/000091224, PMID 16446540

Rist PM, Berger K, Buring JE, Kase CS, Gaziano JM, Kurth T. Alcohol consumption and functional outcome after stroke in men. Stroke 2010;41:141-6. doi: 10.1161/STROKEAHA.109.562173, PMID 19910548

Djoussé L, Ellison RC, Beiser A, Scaramucci A, D’Agostino RB, Wolf PA. Alcohol consumption and risk of ischemic stroke: The Framingham Study. Stroke 2002;33:907-12. doi: 10.1161/ hs0402.105245, PMID 11935035

Curb JD, Abbott RD, Rodriguez BL, Masaki KH, Chen R, Popper JS, et al. High density lipoprotein cholesterol and the risk of stroke in elderly men: The Honolulu heart program. Am J Epidemiol 2004;160:150-7. doi: 10.1093/aje/kwh177, PMID 15234936

Lee MJ, Lee C, Chung CS. The migraine-stroke connection. J Stroke 2016;18:146-56. doi: 10.5853/jos.2015.01683, PMID 27283278

Champaloux SW, Tepper NK, Monsour M, Curtis KM, Whiteman MK, Marchbanks PA, et al. Use of combined hormonal contraceptives among women with migraines and risk of ischemic stroke. Am J Obstet Gynecol 2017;216:489.e1-7. doi: 10.1016/j.ajog.2016.12.019, PMID 28034652

Shi Z, Guan Y, Huo YR, Liu S, Zhang M, Lu H, et al. Elevated total homocysteine levels in acute ischemic stroke are associated with long-term mortality. Stroke 2015;46:2419-25. doi: 10.1161/ STROKEAHA.115.009136, PMID 26199315

World stroke Day 2022. Available from: https://www.who.int/srilanka/ news/detail/29-10-2022-world-stroke-day-2022#:~:text=Stroke%20 is%20the%20leading%20cause

Bath P. High blood pressure as risk factor and prognostic predictor in acute ischaemic stroke: When and how to treat it? Cerebrovasc Dis 2004;17 (Suppl 1):51-7. doi: 10.1159/000074795, PMID 14694280

Fazal N, Saif S. Association between NIH stroke scale score and functional outcome in acute ischemic stroke. Pak Armed Forces Med J 2014;64:585-90.

Published

07-11-2023

How to Cite

CHANDRA SHEKAR K, H. S. POLISETTI, K. K, and V. R. KR. “EVALUATION OF RISK FACTORS AND THEIR PROGNOSTIC VALUE IN PATIENTS WITH ISCHEMIC STROKE”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 11, Nov. 2023, pp. 150-6, doi:10.22159/ajpcr.2023.v16i11.48012.

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Original Article(s)