A Prospective Observational Study on Prescribing Pattern and Outcome of Acute Stroke from a Tertiary Care Hospital in Bengaluru, India
Dr. R Jyothi,
No. 360, Sainandana, Turahalli, Bangalore, Bangalore, Karnataka, India.
Introduction: Stroke is the most common cerebrovascular disorder and a second leading cause for death. Early diagnosis and treatment of stroke along with controlling of risk factors, post stroke infection and rehabilitation can enhance patient outcomes. Stroke is an important economic burden for the society, requiring increasing attention for more effective healthcare planning and resources allocation.
Aim: To determine the prescribing pattern, risk factors and outcome of acute stroke in a tertiary care hospital.
Materials and Methods: A prospective observational study was conducted in the Department of Medicine, at Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bangalore, Karnataka, India, from January 2018-June 2019 for 18 months. After approval and clearance obtained from the Institutional Ethics Committee, 100 acute stroke subjects of either gender with or without co-morbidities were included in the study. Relevant information about the ongoing drug therapy, co-morbidities, personal and past history were obtained. The outcome of the stroke was assessed by Modified Rankin Scale (mRS). Chi-square test was used for categorical data, student t-test for continuous data and Analysis of Variance (ANOVA) test for temporal change in mean mRS.
Results: The mean age of the subjects in the study was 68.41±12.98 years. Ischaemic stroke (72%) was more common than haemorrhagic stroke (28%). Hypertension and diabetes were significantly associated with stroke with p-value of 0.04 and 0.02 respectively. Association of smoking and alcohol with stroke was significant with p-value of 0.01 and 0.001 respectively. The most commonly prescribed drugs were aspirin, clopidogrel and statins. The mean mRS at admission for both ischaemic and haemorrhagic stroke came down after 28 days with treatment and rehabilitation. At the end of 28th day Ischaemic Stroke showed better outcome than haemorrhagic stroke (p-value: 0.03).
Conclusion: Early diagnosis, lifestyle changes and combination drug therapy reduce complication of stroke and improve patients’ outcome. Risk factors such as hypertension, diabetes mellitus, smoking and alcohol should be controlled. Antiplatelet agents, antihypertensive agents and statins are commonly prescribed for secondary prevention and treatment of stroke. Greater awareness is needed to reduce the burden of stroke.