Abstract Details

Title Clinical Features and Management of Ischemic Stroke in Pakistan

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 031

Objective

Background BACKGROUND: Very few prospective studies from the developing world document clinical features and management of acute ischemic stroke. However, management in the developing world is based largely on studies and trials conducted in the west.

Design/Methods DESIGN/METHODS: This is an institutional review board approved prospective cohort study of 285 consecutive stroke patients admitted to the Shifa International Hospital Islamabad, Pakistan between July 1st 2011 to June 30th 2012. Daily admission data regarding demographics, risk factors, clinical presentation, investigations, management and 90 day follow ups was collected.

Results RESULTS: There were 285 patients with a mean age of 63 (range: 26-95) years (f=134, m=151). Risk factors included hypertension in 227 (80%), diabetes in 151 (53%), dyslipidemia in 127 (45%), ischemic heart disease in 63 (22%), atrial fibrillation in 33 (12%), past TIA/stroke in 82 (29%), and smoking both current (42, 15%), and ex (20, 7%). Uncontrolled and/or unrecognized disease was present in 81 (36%) hypertensives, 51 (34%) diabetics, 100 (79%) dyslipidemics, 21 (33%) ischemic heart disease patients, 13 (39%) atrial fibrillation patients, and 41 (50%) of patients with past stroke or TIA. The mean HbA1c value was 7.8. Clinical presentation included NIHSS (10.16), unilateral weakness (114 right-sided, 95 left-sided), aphasia (66), dysarthia (111) ataxia (30), sensory disturbances (right-sided 13, left-sided 29), and visual disturbances (23). Prognosis (Modified Rankin Scale at 90 days) will be reviewed at presentation.

Conclusions CONCLUSIONS: Risk factors for stroke in Pakistan are similar to patients in North America. However the majority of patients are either unaware or have poor management of stroke risk factors. Efforts at risk factor management are important to reduce the burden of stroke in this population.

Authors/Disclosures
Hiba Khan PRESENTER	No disclosure on file
	No disclosure on file
Ismail A. Khatri, MD, MBBS, FAAN (King Abdul Aziz Medical City, Ministry of National Guard Health Affairs)	Dr. Khatri has nothing to disclose.
	No disclosure on file
Jan Claassen, MD, PhD (Columbia University College of Physicians & Surgeons)	Dr. Claassen has stock in iCE Neurosystems. The institution of Dr. Claassen has received research support from NINDS. The institution of Dr. Claassen has received research support from McDonnel Foundation. Dr. Claassen has received publishing royalties from a publication relating to health care. Dr. Claassen has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
Jamal F. Khattak, MD	Dr. Khattak has nothing to disclose.
	No disclosure on file

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