Study of Aetiological and Clinical Profile of Stroke Patients with Special Reference to Baseline Intracranial Haemorrhage Score in Haemorrhagic Stroke in North East India - A Hospital Based Cross-Sectional Study

Abstract

BACKGROUND As defined by World Health Organization (WHO), stroke is accountable for 5 million deaths and 5 million disabled patients throughout the world. The prevalence of stroke is in rising trend in Indian subcontinent and therefore is a source of socioeconomic concern. This study was conducted to evaluate the aetiological and clinical profile in stroke patients with special reference to baseline intracranial haemorrhage (ICH) score in haemorrhagic stroke in North East India. METHODS The study was carried out among in-patients of Medicine Department at Assam Medical College and Hospital, Dibrugarh in North East India from March 2019 to February 2020. A total of 112 patients who presented with symptoms suggestive of stroke were assessed. Mean ± standard deviation was used to express continuous variables. Frequency and percentage were used to express categorical variables. Test of significance for qualitative data was assessed by chi-square test (for 2 x 2 tables). P-value less than 0.05 was taken as statistically significant. RESULTS In our study stroke was common in 40 – 60 years age group which comprised 50 % of total patients. Stroke was more common in males with a sex ratio of 1.24:1. 73.2 % of patients suffered haemorrhagic stroke and 22.3 % suffered ischemic stroke whereas 4.5 % suffered cardio-embolic stroke. Hypertension was the most prevalent and an important risk factor with 80.3 % (P = 0.001), followed by smoking with 39 % (P = 0.021), chronic alcohol consumption with 37 % (P = 0.028) and diabetes with 22 %. The most common site of haemorrhage was basal ganglia (28 %) followed by thalamus (24 %). Patients presenting with intraventricular extension, infratentorial location, low Glasgow Coma Scale (GCS) score (< 4) or having high ICH score (≥ 3) at the time of presentation were associated with increased mortality in haemorrhagic stroke (P = 0.010). CONCLUSIONS Haemorrhagic strokes (73.2 %) are the most common type. Hypertension is the most prevalent and an important risk factor (80.3 %). Basal ganglia (28 %) are the most common sites involved in haemorrhagic stroke; infratentorial location is associated with poor prognosis. Patients presenting with low GCS score (< 4) or having high ICH score (≥ 3) at the time of presentation are associated with increased mortality in haemorrhagic stroke. KEY WORDS Stroke, Hypertension, Basal Ganglia, GCS Score, ICH Score