CLINICAL CHARACTERISTICS OF STROKE IN DUHOK PROVINCE
Background: Cerebrovascular accidents (stroke) are considered the second leading factor contributing to mortality and they are the third cause of disability. Stroke in low- and middle-income countries (LMIC) has doubled over the last four decades but little attention has been paid to this issue in this region.
Objectives: The distribution of stroke and its sub-type including pathologically ischemic (major vs. small vessel), intracerebral hemorrhage, subarachnoid hemorrhage and venous infarction and anatomically (anterior vs. posterior circulation), lobes localization were explored in this study.
Methods: In this large cross-sectional study, the patients who attended three general hospitals in Duhok governorate and were diagnosed with stroke and its types were included. The patients who attended the out-patient clinic of the hospitals were examined physically and clinically for the eligibility criteria.
Results: The mean age of the patients who were included in this study was 64.73 (SD: 12.55) ranged between 16 and 105 years. The mean BMI of the patients was 26.34 (SD: 3.90) with the dominant overweight population (40.8%) followed by normal weight (37.2%) and obese (21.4%). The study showed that most of the patients had hypertension (78.0%), dyslipidemia (63.1%) and sedentary lifestyle (52.9%). The prevalence of stroke subtypes was macrovascular stroke (48.7%), lacunar stroke (32.9%), ICH (15.7%), SAH (2.5%), and venous (0.2%). The prevalence of clinical risk factors was IHD (25.5%), past CVA (37.8%), and AF (25.4%). The study showed that patients with macrovascular and lacunar stroke were significantly older (65.80 and 65.84 years, respectively) compared to other stroke subtypes. The BMI of the patients with stroke subtypes was not significantly different, but the mean of all of them was overweight (P=0.453). The lowest rate of stroke subtypes was observed in patients with blood group O (P=0.969). The patients with T2DM (P<0.001) and dyslipidemia (P=0.003), and those patients with sedentary lifestyles (P=0.034). The prevalence of stroke subtypes was significantly more prevalent in patients without IHD (P=0.046) and those without past CVA (P=0.017). The prevalence of stroke subtypes was not significant between those patients with and without AF (P=0.713).
Conclusions: The present study showed that macrovascular and lacunar strokes were the most prevalent types of stroke in this region. The stroke subtypes were more prevalent in patients with overweight, diabetes mellitus, and hypertension.
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