Ischemic Strokes: Observations from a Hospital Based Stroke Registry in Bangladesh

Abstract

Background. Stroke is an important morbidity for low and middle income countries like Bangladesh. We established the first stroke registry in Bangladesh. Methods. Data was collected from stroke patients who were admitted in Department of Neurology of BIRDEM with first ever stroke, aged between 30 and 90 years. Patients with intracerebral hemorrhage, subarachnoid and subdural hemorrhage, and posttrauma features were excluded. Results. Data was gathered from 679 stroke patients. Mean age was 60.6 years. Almost 68% of patients were male. Small vessel strokes were the most common accounting for 45.4% of all the patients followed by large vessel getting affected in 32.5% of the cases. Only 16 (2.4%) died during treatment, and 436 (64.2%) patients had their mRS score of 3 to 5. Age greater than 70 years was associated with poor outcome on discharge [OR 1.79 (95% CI: 1.05 to 3.06)] adjusting for gender, duration of hospital stay, HDL, and pneumonia. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity explained the Barthel score. Conclusion. Mortality was low but most of patient had moderate to severe disability at discharge. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity influenced the Barthel score.

Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

“…It is also shown from our study that hypertension, diabetes, AF, dyslipidemia were mostly seen in the elderly age group of more than 70 years, whereas dyslipidemia and hypertension were commonly observed in young age groups of age less than 45 years. This was consistent with the study done in Bangladesh where risk factors comparison was done with similar age groups 13 .…”

“…Age is one of the non-modifiable risk factor of stroke. Mean age of the stroke patients which was around 63 was consistent with the findings from a similar stroke registry in Nepal (61) 8, 9, India (63) 11 , China (60) 12 , Bangladesh (60) 13 . However, in contrast to the western countries (69 years in USA and 71 years in Italy), the mean age of the stroke onset was higher 14 .…”

“…Among 73 patients out of a total of 92 who underwent the imaging study, carotid stenosis more than 70% was seen in 14(15.29%) of the cases which was higher than the study done in Pakistan, but however the percentages are as high as 39% or higher mentioned in some local journals 17 . A recent study of 672 stroke patients showed evidence of high-grade stenosis (70%-99%) in 12% patients 18. Similarly studies have shown anterior circulation infarct to be the most common followed by lacunar infract which was similar to the study done in Indo-American stroke patients in New Jersey America 11,13 . However a few other studies from India and Pakistan also showed that lacunar strokes are the predominant stroke subtype 19,20,21,22 .…”

“…A diagnosis of hypertension was made if the patient's systolic and diastolic blood pressure surpassed 140 and/or 90 millimeters of mercury respectively on repeated measurements during hospitalization or physical evaluation, or if the patient was being treated with antihypertensive drugs at the time of admission. A diagnosis of diabetes mellitus was based on self-reporting of the disease, or an observed fasting serum glucose level of 126 mg/dL or more, or if the patient was being treated with insulin or hypoglycemic drugs 13 . Dyslipidemia was defined as fasting serum total cholesterol of 200 mg/dL or more, a serum lowdensity lipoprotein (LDL) of 100 mg/dL or more, and/ or a serum high-density lipoprotein (HDL) of 40 mg/dL or lower.…”

Early versus late rehabilitation for stroke survivors: A prospective study

“…Mean age of the stroke patients is similar to stroke registry in Bangladesh and Pakistan. 19, 20 According to stroke registry in USA the mean age of stroke is 71 years 21 . The women were older.…”