Kulshrestha Malini
Assistant Professor Department of Medicine.
J Clin Diagn Res. 2013 Jan;7(1):127-31. doi: 10.7860/JCDR/2012/4918.2686. Epub 2012 Nov 10.
Stroke is a growing epidemic in the developing countries. The risk factors of stroke are the same as those of atherosclerosis, but the relative incidences of the various risk factors keep changing with time and cultural and environmental factors. So, a periodic analysis should be done.
The generation of the data which pertained to the clinical profile of stroke in our institution by using the WHO Steps Stroke Manual, version 2 and to make note of the risk factors and the correlation of the outcome with the Glasgow's Coma Scale (GCS) at admission and with the Modified Rankin Scale (MRS) on the 28th day.
A prospective study was conducted on 157 cases of stroke patients who were admitted to the Medicine Department of a tertiary care institute during June 2011 through June 2012.
Amongst the 157 cases (92 males and 65 females), 86 % were above 40 years of age and this was the most prevalent age group in the age range of 51-60 years. The risk factor analysis showed hypertension as the most prevalent risk factor, followed by diabetes cum hypertension. Hemiplegia/hemi paresis was the most common presentation, followed by aphasia. Radiological studies showed that ischaemic strokes were the most frequent ones, followed by haemorrhagic strokes (71 vs. 29 %). Amongst the ischaemic infarcts, the anterior circulation infarct was the most frequent one. The outcome was poor with haemorrhagic strokes and in those who were presented with a GCS of less than 3. The overall mortality was 22.29 %. A significant residual deficit (MRS >3) was seen in 49.7 % of the patients.
There is a need for prospective representative population based surveys viz. the WHO Stroke Steps 2 and 3.Public health measures are essential to enhance the awareness about the importance of knowing the risk factors. Hence, the message which has to be percolated to the masses is - stroke is a 'brain attack' that is preventable.
中风在发展中国家正呈日益流行之势。中风的危险因素与动脉粥样硬化相同，但各种危险因素的相对发生率会随时间以及文化和环境因素而不断变化。因此，应进行定期分析。
运用世界卫生组织《中风防治指南》第2版生成与我院中风临床特征相关的数据，并记录危险因素以及入院时格拉斯哥昏迷量表（GCS）与第28天改良Rankin量表（MRS）结果之间的相关性。
对2011年6月至2012年6月期间入住一家三级医疗机构内科的157例中风患者进行了一项前瞻性研究。
在这157例患者中（92例男性和65例女性），86%年龄在40岁以上，其中51 - 60岁年龄组最为普遍。危险因素分析显示高血压是最常见的危险因素，其次是糖尿病合并高血压。偏瘫/轻偏瘫是最常见的表现，其次是失语。影像学研究表明缺血性中风最为常见，其次是出血性中风（71%对29%）。在缺血性梗死中，前循环梗死最为常见。出血性中风以及入院时GCS评分低于3分的患者预后较差。总死亡率为22.29%。49.7%的患者存在显著的残留功能障碍（MRS＞3）。
有必要进行基于前瞻性代表性人群的调查，即世界卫生组织中风防治步骤2和3。公共卫生措施对于提高对了解危险因素重要性的认识至关重要。因此，必须向大众传达的信息是——中风是一种可预防的“脑部攻击”。
