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Evaluating the prevalence of risk factors among the stroke patients who referred at fifteen months period in university affiliated Hospital ,Tehran, Iran
Introduction:
Stroke is the second leading cause of death above the age of 60 and has been ranked sixth among top six economical burden of disease which is expected to come to fourth place by 2020.
More than 80 percent of stroke occurred in developing countries. The major reason of this varied prevalence of stroke and its types in different populations is various pattern of risk factors and demographic characteristics related to a specific region. Definitely investigation on frequency of stroke incidence and its clinical pattern in different countries, plays an important role in understanding the pattern of disease.
Stroke is a preventable disease and except age, gender and race which are non modifiable in atherosclerosis the others are preventable. Numerous stroke registries worldwide have been published in order to find out the risk factors within different societies (1-3). Theses stroke registries are big steps toward reducing the prevalence of stroke and present effective solution for diminishing economic and psychological burden of disease in both families and societies.
The goal of this study is to investigate demographic features and risk factors in 15 months period in one of the Tehran University of Medical Sciences affiliated hospital.
Method:
In a cross sectional - approved by neurology research center- study done on 120 patients admitted for acute stroke (proven by history and imaging) to the emergency department of Imam Khomeini hospital complex between April 2013 to July 2014, They were questioned in demographic information, past medical history and habitual history and the designed questionnaire were filled. Then statistical data, regarding the frequency parameters, will be analyzed to obtain the prevalence of each item identified in this study. To determine the association of risk factors with other variable and appropriate table were used. Data were analyzed by SPSS 16th version..
Result:
The mean age of patients is 63/4±14/7 and 12/5% of them are less than 45 years old. 78% suffered from ischemic stroke and 22% from hemorrhagic ones. The prevalence rate were male 58/3% ; illiterate and elementary education 85/5%; hypertension, 78/3%; diabetes, 51/4%; hyperlipedemia, 51/8%, history of cardiac disease 38/3% which mostly belongs to atrial fibrillation (13/3%); TIA, 10/1%; previous stroke, 27/7%; history of migraine headache 4/2%; cigarettes and shish a addiction, 19/3%; opium user 13/3% and prevalence of family history of heart disease and stroke is 15%.
Prevalence of patient with one risk factor is 4/5%, three risk factors is 17/3%, four risk factors is 30.0% and the other patients have five risk factors or more (Table 1).
In more than half percent of patients the modifiable risk factors is predominant. In this study, except TIA, headache and being male the other risk factors are predominant in hemorrhagic but just hypertension and previous stroke in hemorrhagic stroke is significantly higher than ischemic stroke (P<0.05). Being male is significantly higher in ischemic stroke than hemorrhagic ones. In comparison of pattern of risk factors between the two genders, prevalence of hyperlipedemia is significantly higher among females. Cigarettes and opium users is significantly higher in males and in the other risk factors there is no considerable difference.
Conclusion:
According to the results of this study, more than half of the patients suffering three major risk factors: hypertension, hyperlipidemia and diabetes.
These three diseases are the most important and preventable risk factors that can be seen among the patients. In case of ignoring these risk factors which are the main criteria for metabolic syndrome, they can led to dangerous consequences such as heart attacks , strokes, liver failure within the society.in case of developing any of these risk factors , prognoses will also be affected considerably.
Another problem is that most of the patients were suffering from the risk factor of illiteracy that could lead to the improper lifestyle, Reducing capacity to control other risk factors and Disruption of patient healthcare. The results indicated that the prevalence of known risk factors for stroke in this study, are as the same as developing countries and significantly higher than developed countries. Considering that the prevalence of stroke and its risk factors in Iran is more or less vague, further studies on the prevalence of risk factors and reaching the pattern of these risk factors, is essential . Due to the fact that results of this study are different from similar articles of other countries regarding the prevalence of risk factors in both stroke and in each of the two sexes, more comprehensive statistical research should be done on this issue (Table 2).
As the result, a unique and specific pattern of risk factors prevalence in Iran can be obtained. Undoubtedly, these findings play an important role in devising a comprehensive work up relating to stroke patients.
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