Differences in ischaemic and haemorrhagic strokes in Sri Lanka: 7-year data from the Ragama Stroke Registry

Abstract

OBJECTIVE:We sought to describe the differences in stroke characteristics of patients with ischaemic and haemorrhagic stroke attending a Sri Lankan tertiary care hospital. BACKGROUND:The burden of stroke in South Asia is high, but epidemiological data are limited from the region. DESIGN/METHODS:The Ragama Stroke Registry is the first comprehensive stroke registry in Sri Lanka capturing data of all stroke patients admitted to an entire hospital. We collected data from all consenting patients with stroke admitted to the Colombo North Teaching Hospital over a seven-year period. We compared data from ischaemic stroke patients (IS group) with intracerebral haemorrhage patients (ICH group) regarding demographic characteristics, clinical features, risk factors, stroke severity and early disability. RESULTS:A total of 2690 patients were studied [mean age (SD) 64.4 (12.3) years; 58.6[percnt] males]; IS group- 2185 patients (81.3[percnt]); ICH group- 411 patients (15.3[percnt]). No differences were noted in age & sex distribution between ICH and IS groups. ICH patients presented to hospital earlier (<6 hours- ICH 74.5[percnt], IS 54.0[percnt], p<0.05). Altered consciousness, dysphasia, dysphagia, gaze palsy and bladder involvement were commoner among ICH patients (p<0.05). Previous history of stroke/ TIA, diabetes, heart disease, obesity/overweight and smoking were commoner in IS group. ICH patients presented with more severe strokes (NIHSS score >7 in ICH 67.6[percnt] vs. IS 43.8[percnt], p<0.05), and had more severe initial disability according to Barthel index and modified Rankin scale (p<0.05). CONCLUSIONS:Clinical and risk factor profiles were different between ICH and IS patients. Stroke severity and functional disability were higher among ICH patients. Study Supported by:Ragama Stroke Registry has been partly supported by research grants from the University of Kelaniya and Research Institute, International Medical Centre of Japan.

Disclosure: Dr. Ranawaka has nothing to disclose. Dr. Peiris has nothing to disclose. Dr. Thirumavalavan has nothing to disclose. Dr. Premawansa has nothing to disclose. Dr. Kasthuriratne has nothing to disclose.