Research Article
Volume 7 Issue 8 - 2020
Short Term Outcome of Acute Ischemic Stroke Patients
Ratindra Nath Mondal1*, Mahajabin Jamal2, Md Atiqul Islam3, Md Mahfuj-Ul-Anwar2, Md Mokhlesur Rahman Sarker2, Shah Md Sarwer Jahan2, Moni Rani4 and Md Zakir Hossain5
1Hypertension and Research Center, Rangpur, Bangladesh
2Rangpur Medical College, Bangladesh
3Pabna Medical College, Bangladesh
4Rajshahi Medical College, Bangladesh
5Shaheed Ziaur Rahman Medical College, Bangladesh
*Corresponding Author: Ratindra Nath Mondal, Hypertension and Research center, Rangpur, Rangpur, Bangladesh.
Received: June 17, 2020; Published: July 08, 2020




Abstract

Background: Stroke is a major cause of disability and death. In 2013, a total of 3.3 million individuals died of ischemic stroke worldwide.

Materials and Methods: This was an observational study, carried out in department of Medicine of Rangpur Medical College Hospital, from 1st July 2017 to 31st December 2017. Ischemic stroke patients were included in the study.

Results: During the study period we have studied over 138 patients, mean age of the patients at the time of stroke were 61.26 years, male were more than male (60.1% vs 39.9%). Mortality within 30 days for patients with ischemic stroke was 18.1% (25), among them 60% were female and 40% male. In this study mean size of infarction was 6.25 mm2 (larger one was 48 mm2). Mortality at 30th day was 45.8% in those who had infarction >10 mm2 and 12.3% who had infarction size < 10 mm2. According to the arterial territory involved lacunar stroke syndrome (LACS) was the maximum 34.8%. Mortality at 30th day was more in total anterior circulation syndrome (TACS) group. Mean Glasgow coma scale (GCS) of the patients at the time of admission was 11.53. There was improvement of GCS from presentation (GCS 11.77) to discharge (13.51) in survived patients. There was no significant improvement occurred from presentation (GCS 6.10) to after 24 hours (6.12) in case of death cases. GCS at presentation and arterial territory involvement was a good predictor of mortality within 30 days. Those who had GCS < 10 at presentation, majority were TACS group (37.5%), among them 77.78% died within 30 days.

Conclusion: Short term mortality (30 days) is high in ischemic stroke. GCS at presentation and after 24 hours, size of infarction arterial territory involvement may be good predictor of mortality within 30 days.

Keywords: Short Term; Ischemic; Mortality; Rangpur

References

  1. Hosomi N., et al. “Predictors of intracerebral hemorrhage severity and its outcome in Japanese stroke patients”. Cerebrovascular Diseases 27 (2009): 67-74.
  2. Kim KH. “Predictors of 30-day mortality and 90-day functional recovery after primary intracerebral hemorrhage: hospital based multivariate analysis in 585 patients”. Journal of Korean Neurosurgical Society 45 (2009): 341-349.
  3. Wong KS. “Risk factors for early death in acute ischemic stroke and intracerebral hemorrhage: a prospective hospital-based study in Asia”. Asian Acute Stroke Advisory Panel Stroke 30 (1999): 2326 -2330.
  4. Mukherjee D and Patil CG. “Epidemiology and the global burden of stroke”. World Neurosurgery 76 (2011): S85.
  5. Murray CJ and Lopez AD. “Alternative projection of mortality and disability by cause 1990-2020. Global burden of disease study”. Lancet 349 (1997): 1498-1504.
  6. Dashe JF., et al. “Stroke prognosis in adults”. UpToDate (2013).
  7. Schiemanck SK., et al. “Predictive value of ischemic lesion volume assessed with magnetic resonance imaging for neurological deficits and functional outcome poststroke: A critical review of the literature”. Neurorehabilitation and Neural Repair 20 (2006): 492.
  8. Vogt G., et al. “Initial lesion volume is an independent predictor of clinical stroke outcome at day 90: an analysis of the Virtual International Stroke Trials Archive (VISTA) database”. Stroke 43 (2012): 1266.
  9. WHO MONICA Project Investigators. “The World Health Organization MONICA Project (Monitoring trends and determinants in cardiovascular disease)”. Journal of Clinical Epidemiology 41 (1988): 105-114.
  10. Jarman P. “Neurological disease”. In: Kumar P, Clark M, editors. Clinical Medicine. 8th edition. London. Saunders Elsevier (2012).
  11. Langhorne P. “Stroke disease”. In Walker BR, Colledge NR, Ralston SH, Penman ID, editors. Davidson’s Principles and Practice of Medicine”. 22nd London. Churchill Livingstone Elsevier (2014).
  12. Weimar C., et al. “Age and National Institutes of Health Stroke Scale Score within 6 hours after onset are accurate predictors of outcome after cerebral ischemia: development and external validation of prognostic models”. Stroke 35 (2004): 158.
  13. Adams HP Jr., et al. “Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)”. Neurology 53 (1999): 126.
  14. Jørgensen HS., et al. “Stroke. Neurologic and functional recovery the Copenhagen Stroke Study”. Physical Medicine and Rehabilitation Clinics of North America 10 (1999): 887.
  15. Saposnik G., et al. “IScore: a risk score to predict death early after hospitalization for an acute ischemic stroke”. Circulation 123 (2011): 739.
  16. Koennecke HC., et al. “Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit”. Neurology 77 (2011): 965.
  17. Hankey GJ., et al. “Rate, degree, and predictors of recovery from disability following ischemic stroke”. Neurology 68 (2007): 1583.
  18. Andersen KK., et al. “Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke”. Stroke 42 (2011): 2806.
  19. Vogt G., et al. “Initial lesion volume is an independent predictor of clinical stroke outcome at day 90: an analysis of the Virtual International Stroke Trials Archive (VISTA) database”. Stroke 43 (2012): 1266.
  20. Saver JL and Altman H. “Relationship between neurologic deficit severity and final functional outcome shifts and strengthens during first hours after onset”. Stroke 43 (2012): 1537.
  21. Béjot Y., et al. “Poststroke disposition and associated factors in a population-based study: the Dijon Stroke Registry”. Stroke 43 (2012): 2071.
  22. Baird AE., et al. “A three-item scale for the early prediction of stroke recovery”. Lancet 357 (2001): 2095.
  23. König IR., et al. “Predicting long-term outcome after acute ischemic stroke: a simple index works in patients from controlled clinical trials”. Stroke 39 (2008): 1821.
  24. Robertson CE., et al. “Recovery after spinal cord infarcts: long-term outcome in 115 patients”. Neurology 78 (2012): 114.
  25. Coutts SB., et al. “What causes disability after transient ischemic attack and minor stroke?: Results from the CT and MRI in the Triage of TIA and minor Cerebrovascular Events to Identify High Risk Patients (CATCH) Study”. Stroke 43 (2012): 3018.
  26. Rost NS., et al. “Stroke severity is a crucial predictor of outcome: An international prospective validation study”. Journal of the American Heart Association (2016): 5.
  27. H-C., et al. “Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit”. Koennecke Neurology 77 (2011): 965-972.
  28. Konig IR., et al. “Predicting long-term outcome after acute ischemic stroke: A simple index works in patients from controlled clinical trials”. Stroke 39 (2008): 1821-1826.
  29. Kammersgaard LP., et al. “Short- and long-term prognosis for very old stroke patients. The Copenhagen stroke study”. Age and Ageing 33 (2004): 149-154.
  30. HN Harsha Kumar., et al. “A Study on Stroke and its Outcome in Young adults (15-45 Years) from coastal South India”. Indian Journal of Community Medicine 1 (2011): 62-65.
  31. Lisovoski F and Rousseaux P. “Cerebral infarction in young people: A study of 148 patients with cerebral angiography”. Journal of Neurology, Neurosurgery, and Psychiatry 54 (1991): 576-577.
  32. Bogousslavsky J and Regli F. “Iscemic stroke in adults younger than 30 years of age: Cause and prognosis”. Archives of Neurology 44 (1987): 479-482.
  33. Sukdeb Das., et al. “Short term mortality predictors in acute stroke”. Annals of Neurosciences 2 (2012): 61-67.
  34. Broderick JP., et al. “Incidence rates of stroke in the eighties: the end of the decline in stroke?” Stroke 20 (1989): 577-582.
  35. Bamford J., et al. “A pro-spective study of acute cerebrovascuar disease in the community: the Oxfordshire Community Stroke Project: 1981-86”. Journal of Neurology, Neurosurgery, and Psychiatry 53 (1990): 16-22.
  36. Giroud M., et al. “Cerebral haemorrhage in a French prospective population study”. Journal of Neurology, Neurosurgery, and Psychiatry 54 (1991): 595-598.
  37. Fogelholm R., et al. “Primary intracerebral haemorrhage in the Jyvaskyla region, Central Finland, 1985-89: incidence, case fatality rate, and functional outcome”. Journal of Neurology, Neurosurgery, and Psychiatry 55 (1992): 546-552.
  38. Mondal RN., et al. “Short-term predictors of mortality among patients with hemorrhagic Stroke”. World Heart Journal4 (2014): 273-282.
  39. Hossein Ali Ebrahimi., et al. “Study of the involved vascular territories in patients with ischemic stroke in Kerman, Iran”. ARYA Atherosclerosis 5 (2016): 250-253.
  40. Sheikh K., et al. “Predictors of mortality and disability in stroke”. Journal of Epidemiology and Community Health 37 (1983): 70-74.
  41. Ebell MH. “Predicting prognoses in patients with acute stroke”. American Family Physician 77 (2008): 1719-1720.
  42. Li C., et al. “Blood pressure control and risk of stroke. A population based prospective cohort study”. Stroke 36 (2005): 725-730.
  43. Jafar TH. “Blood pressure, diabetes and increased dietary salt associated with stroke -results from a community-based study in Pakistan”. Journal of Human Hypertension 1 (2006): 83-85.
  44. Ahmed R., et al. “Predictors of in hospital mortality for intracerebral hemorrhage: A hospital based study in Pakistani adults”. Journal of Stroke and Cerebrovascular Diseases 10 (2001): 122-127.
Citation: Ratindra Nath Mondal., et al. “Short Term Outcome of Acute Ischemic Stroke Patients”. EC Cardiology 7.8 (2020): 10-18.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


June Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the June issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 06, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk