Zafar Faleha, Tariq Waseem, Shoaib Raja Farhat, Shah Ahmed, Siddique Maimoona, Zaki Abdullah, Assad Salman
Department of Neurology, Shifa International Hospital, Islamabad, Pakistan.
Asian J Neurosurg. 2018 Oct-Dec;13(4):984-989. doi: 10.4103/ajns.AJNS_365_16.
The purpose of this study was to determine the frequency of ischemic stroke subtypes based on Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification at a tertiary care center in Pakistan.
A cross-sectional study was conducted in Stroke Unit of Shifa International Hospital, Islamabad. We included 145 patients who presented to us from November 2015 to February 2016 with radiological confirmed neurological deficits consistent with ischemic stroke. The causes of ischemic stroke were classified according to TOAST criteria. Regression analysis and Chi-square test were used to compute value.
Among the 145 patients diagnosed with ischemic stroke, there were 54.1% males and 45.9% females with a mean age of 65 ± 14 years. Nearly 62.7% patients had hypertension (HTN) as the most common risk factor, followed by 38.6% diabetes mellitus (DM), 27.5% heart failure, 19.3% valvular disease, 18.6% previous stroke, 16.4% smoking, 15.1% dyslipidemia, 13.7% ischemic heart disease, and 13.1% atrial fibrillation. HTN was significantly associated with large vessel disease ( = 0.028). DM was significantly associated with small vessel disease ( = 0.001). Smoking and atrial fibrillation both were associated with unknown etiology of stroke ( = 0.001 and = 0.039, respectively). Most common etiology of stroke was cardioembolism (40%), and atrial fibrillation is found to be the most common cause of cardioembolic stroke with 30.6% incidence.
Our study concludes that cardioembolic stroke is the most common cause of acute ischemic stroke in our stroke unit. Atrial fibrillation is found to be the most common cause of cardioembolic stroke.
本研究旨在根据巴基斯坦一家三级医疗中心的急性卒中治疗中奥扎格雷钠试验（TOAST）分类法，确定缺血性卒中亚型的发生率。
在伊斯兰堡的希法国际医院卒中单元进行了一项横断面研究。我们纳入了2015年11月至2016年2月期间前来就诊的145例经影像学证实有与缺血性卒中相符的神经功能缺损的患者。根据TOAST标准对缺血性卒中的病因进行分类。采用回归分析和卡方检验计算值。
在145例诊断为缺血性卒中的患者中，男性占54.1%，女性占45.9%，平均年龄为65±14岁。近62.7%的患者以高血压（HTN）为最常见的危险因素，其次是38.6%的糖尿病（DM）、27.5%的心力衰竭、19.3%的瓣膜病、18.6%的既往卒中、16.4%的吸烟、15.1%的血脂异常[纠正为：血脂异常（dyslipidemia）]、13.7%的缺血性心脏病和13.1%的心房颤动。高血压与大血管疾病显著相关（P = 0.028）。糖尿病与小血管疾病显著相关（P = = 0.001）。吸烟和心房颤动均与卒中的不明病因相关（分别为P = 0.001和P = 0.039）。卒中最常见的病因是心源性栓塞（40%），发现心房颤动是心源性栓塞性卒中最常见的原因，发生率为30.6%。
我们的研究得出结论，心源性栓塞性卒中是我们卒中单元急性缺血性卒中最常见的原因。发现心房颤动是心源性栓塞性卒中最常见的原因。
