RISK FACTORS FOR STROKE IN KASHMIR VALLEY.

ABSTRACT Background: Stroke is usually end result of predisposing conditions that originated years before the ictus. Identification of its risk factors can help in planning preventive strategies. Objective: To study the risk factor profile of stroke and impact of various risk factors on outcome of stroke. Methodology: A hospital based descriptive study was conducted at SMHS hospital, Srinagar (J&K) a tertiary care teaching institute between May 2011 to December 2012, in which 503 patient who presented to hospital with clinical features of stroke confirmed by brain imaging were included. Patients were then investigated for presence of conventional risk factors and their impact on mortality and functional outcome were noted. Results: The age of most stroke patients was between 50-60 years. It afflicted higher percentage of males (64%) than females (36%) and stroke subtypes showed preponderance of haemorrhagic stroke in 280 (55.7%) as against ischemic stroke 223 (43.3%). Hypertension was the most common risk factor in 411 patients (81.7%) followed by smoking in 320 (63.3%), dyslipidemia in 128 (25.4%), diabetes mellitus in 51 (10.1%), heart disease in 42 (8.3%), carotid thickness in 33 (6.6%), past history of stroke in 36 (7.2%), family history of stroke in 14 (2.8%), obstructive sleep apnea in 23 (4.6%), hormonal treatment in 17 (3.4%), use of tranquilizers in 9 (1.8%), claudication in 4 (0.8%). Mortality rate was 20.9% and most of the patients (50.8%) at discharge were dependent on others as per Oxford Handicap Scale. Low GCS, fever and delayed presentation (>24 hours) to hospital were associated with poor outcome. Conclusion: The maximum occurrence of stroke was seen in patients >60 years. Overall male preponderance and higher occurrence of haemorrhagic stroke was seen in our study which may be attributed to presence of single or multiple risk factors.