Comparison among demographics, risk factors, clinical manifestations, and outcomes of stroke subtypes: Findings from a Malaysian stroke-ready hospital

Abstract

Background and Objective: Distinguishing attributes of stroke subtypes is crucial to establish appropriate planning for patient care and preventive measures. This study aims to compare the associations among demographic characteristics, risk factors, clinical manifestations, and outcomes of different stroke subtypes in a Malaysian stroke-ready hospital. Methods: The study utilized data that were collected from the local hospital-based stroke database, which is part of the Perai Regional Integrated Stroke Intervention System. The database is representative of the population in mainland Penang. All confirmed local ischaemic stroke (IS) and haemorrhagic stroke (HS) cases aged 18 years and above admitted to Hospital Seberang Jaya from 1st January 2010 to 31st December 2019 were included. Descriptive and inferential statistics were employed. Results: There was a total of 1,805 patients with 1,572 (87.1%) IS patients and 233 (12.9%) HS patients. The mean (SD) age for IS patients was 62.75 (12.08) and 60.51 (13.65) for HS patients. Generally, there were more male than female patients: 957 (60.9%) male IS patients and 137 (58.8%) male HS patients. A significantly higher proportion of IS patients were aged ≥60 years old (59.9%, p=0.021), of Indian origin (15.5%, p=0.034), had diabetes (51.2%, p<0.001), hyperlipidaemia (17.8%, p<0.001), ischaemic heart disease (10.9%, p=0.011) and were smokers (54.2%, p=0.028) as compared to HS patients. The proportion of IS patients who exhibited hemiparesis (76.0%, p=0.012) and speech disturbances (54.8%, p=0.015) was higher than HS patients. Most IS patients ranged from no disability to moderate disability (65.3%, p<0.001) with a length of stay in the hospital of ≤ 7 days (77.6%, p<0.001). Conclusion: Significant differences were observed on risk factors between IS and HS. IS was linked mainly with hemiparesis and speech disturbances, whereas HS patients mainly exhibited headaches, nausea and vomiting, altered sensorium, and seizures, in addition to more severe stroke and poor outcomes.