CLINICAL PROFILE AND OUTCOME OF ACUTE ISCHEMIC STROKE IN PATIENTS WITH HYPERTENSION AND DIABETES MELLITUS: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Stroke is one of the leading causes of mortality and long-term disability worldwide. Acute ischemic stroke is the most common type of stroke and is strongly associated with modifiable vascular risk factors such as hypertension, diabetes mellitus, smoking, dyslipidemia, and sedentary lifestyle. Early recognition of clinical features and timely hospital-based management are essential for reducing complications and improving outcome. Aim: To evaluate the clinical profile, associated risk factors, radiological findings, complications, and outcome of acute ischemic stroke among hospitalized patients. Methods: A prospective observational study was conducted in the Department of General Medicine during 2018 among 140 patients diagnosed with acute ischemic stroke. Patients aged above 18 years with clinically and radiologically confirmed acute ischemic stroke were included. Patients with hemorrhagic stroke, traumatic brain injury, transient ischemic attack, brain tumors, and recurrent stroke were excluded. Detailed history regarding age, gender, hypertension, diabetes mellitus, smoking, alcohol intake, dyslipidemia, and duration of symptoms was recorded. Clinical examination included Glasgow Coma Scale assessment, motor examination, cranial nerve examination, blood pressure measurement, and neurological deficit assessment. Investigations included complete blood count, blood glucose levels, lipid profile, and computed tomography of the brain. Statistical analysis was performed using SPSS software version 20. Chi-square test and independent t-test were used, and a p-value less than 0.05 was considered statistically significant. Results: The mean age of patients was 61.4 ± 11.8 years. Male predominance was observed. Hypertension was the most common risk factor, followed by diabetes mellitus, smoking, dyslipidemia, and alcohol consumption. Hemiparesis was the most common clinical manifestation, followed by facial deviation and speech disturbance. Middle cerebral artery territory infarction was the most frequent radiological finding. Aspiration pneumonia was the most common complication. Poor outcome showed significant association with Glasgow Coma Scale score less than 8, hypertension, diabetes mellitus, and delayed hospital presentation beyond 24 hours. Conclusion: Acute ischemic stroke was commonly observed among elderly patients and was frequently associated with hypertension and diabetes mellitus. Hemiparesis and speech disturbance were common clinical manifestations, while middle cerebral artery territory infarction was the predominant radiological pattern. Early hospital presentation, control of vascular risk factors, and prompt management are essential to reduce stroke-related morbidity and mortality.