Metabolic Disorders and Other Common Risk Factors in Acute Stroke: A Tertiary Hospital Experience

Abstract

Background: Despite categorical milestones improvements in the prevention and treatment over the last decades, stroke is still a  devastating disease. The case fatality of stroke is as high as 40%. Established “traditional” risk factors like hypertension, diabetes mellitus  and dyslipidemia are common in addition to some modifiable risk factors like alcohol and smoking. Stroke patients with advanced renal  function impairments are at high risk due to cardiovascular complications. Studies have shown that increased morbidity, mortality and  disability are common in stroke patients with metabolic disorders or risk factors.

Methodology: This is a cross sectional retrospective  study of 95 patients admitted with acute stroke from June 2020 to July 2021 in the Lagos State University Hospital (LASUTH) ikeja. The institution is a tertiary referral center. The inclusion criteria were patients with acute stroke who were admitted in the acute stroke wards  within 24hours of occurrence and had adequate clinical information and neuroimaging (CT/MRI) reports. Patients with space occupying  lesions or head injury were excluded. The data was analyzed using SPSS 23.0. The analysis included frequency proportion, mean with  standard deviation, percentage tables and suitable graphs. The Chi square test used to determine association among categorical  variables. Statistical significance was taken as P ≤ 0.05.

Result: The mean age of the patients was 61.0 ± 13.4 with age range from 35 to 90  years. There were more males (63.2%) than females (36.8%). Sixty-five (65%) were admitted with hemorrhagic stroke while 35 (35%) had ischemic stroke. The risks factors identified were hypertension (71%), diabetes mellitus (35%), 18 (51.4%) of the DM were controlled while  25 (26.3%) had dyslipidemia Eights subjects (8.0%) had eGFR of 30-59 ml/min. Twenty (20%) took significant alcohol while 8 (8.4%) had  significant smoking history.

Conclusion: The study showed that hemorrhagic stroke was more prevalent than ischemic stroke. The  commonest risk factors identified were diabetes mellitus, hypertension, dyslipidemia and smoking. There was a statistically significant  association between hypertension (P=0.03), Medical history of diabetes (P=0.02) and stroke types. Patients who had history of diabetes   mellitus are 3 times likely to develop ischemic stroke CI at 95% 1.118– 8.141.