Profile of Patients with Stroke in Western Region of Nepal: A Hospital based Retrospective Study

Abstract

Background: Stroke is one of the most common cause of morbidity and mortality worldwide. Approximately 50-85 percent of strokes are due to ischemic cerebral infarction and 7-27 percent to intracerebral hemorrhage. Since the incidence of stroke is increasing in our country, the study aims to identify various factors associated with stroke.
 Materials and Methods: This is a retrospective study of 86 patients admitted in A & B International Hospital, which is a private hospital located in Pokhara ,Nepal from 1st January 2018 to 31st December 2019.The case notes were taken from hospital record section and relevant data extracted and analyzed. Approval from the hospital management was taken prior to collecting the case notes. Patients below 18 years of age, stroke due to trauma were excluded. The data were collected, and were analyzed using SPSS version 20.0 software
 Results: Of the total 86 patients studied, the age range was from 36 years to 94 years with mean age of 64.3 years. Mean age in ischemic stroke was 66.7 years and in hemorrhagic stroke was 54.8 years. Stroke is more common in men than female (2.3:1 ratio) .Ischemic stroke accounted for 80.2 percent of cases and hemorrhagic stroke for 19.2 percent. Most common presentation included limb weakness, facial deviation and speech abnormality. Most common vascular territory involved was MCA territory infarction and small vessel strokes.
 Conclusion: Stroke is prevalent in our country and the incidence rises with age. Ischemic stroke is more prevalent than hemorrhagic stroke. Mean age of hemorrhagic stroke is lower than that of ischemic stroke and hypertension is most commonly associated risk factor for both types of stroke.

Stroke epidemiology and outcomes of stroke patients in Nepal: a systematic review and meta-analysis

“…The sample size of quantitative studies ranged from nine to 1017 participants. Studies were mainly published in national journals (n = 48) [ 10 – 21 , 23 – 35 , 37 , 39 , 41 – 43 , 45 – 56 , 58 – 60 , 63 , 64 ], and only seven studies were published in international journals [ 22 , 36 , 40 , 44 , 57 , 61 , 62 ].…”

“…The details of the outcome parameters are presented in Table 2 under the main focus area. Fifty studies reported on the types of strokes [ 10 – 62 , 64 ], and 44 studies investigated risk factors in stroke patients [ 10 , 12 – 14 , 16 , 18 – 26 , 28 , 30 – 33 , 35 – 37 , 39 – 41 , 43 – 45 , 47 – 54 , 56 – 59 , 61 – 64 ]. Six studies described using CT scan [ 10 , 11 , 18 , 28 , 47 , 53 ].…”

“…Of 44 studies reporting risk factors in stroke patients [ 10 , 12 – 14 , 16 , 18 – 26 , 28 , 30 – 33 , 35 – 37 , 39 – 41 , 43 – 45 , 47 – 54 , 56 – 59 , 61 – 64 ], pooled data showed hypertension as the most prevalent comorbidity in 50.61% of patients, followed by history of smoking (38.65%), significant alcohol intake (27.31%), diabetes (17.39%), dyslipidemia (8.59%) and atrial fibrillation (5.87%) (refer to Table 2 for more details). Other socio-economic data of patients, like ethnicity and profession, is included in ‘Appendix 3 Education, ethnicity, and job of study participants’.…”

“…Only eight studies were rated as the highest level of evidence (LOE 1) [ 17 , 26 , 46 , 51 , 52 , 55 – 57 ]. The vast majority of studies were found to have a low level of evidence (n = 27) [ 10 – 16 , 18 , 20 , 25 , 28 , 31 , 33 , 34 , 37 , 39 , 47 – 50 , 54 , 58 – 60 , 62 – 64 ].…”