Classification Of Subtype Of Acute Ischemic Stroke:Risk Factors,Imaging Variables And Treatment

Objective:Acute stroke is a condition in which poor flow of the blood in the brain causes cell death.It can be either ischemic or hemorrhagic.Stroke subtyping have various purposes,like describing patient's characteristics in different clinical studies,grouping patients for epidemiological study.phenotyping of patients for genetic study,and categorising patients for therapeutic purposes in daily practice.The purpose of this study is to identify the characteristics of different subtypes of acute ischemic stroke,assess the incidence rate and estimate the frequency of various risk factors and treatments among these patients.Methods:In this prospective,cross sectional study total 352 stroke patients falling under our inclusion criteria were recruited.Patients with a diagnosis of acute ischemic stroke admitted in Neurology department of the Second Affiliated Hospital of Kunming Medical University from October 2017 to October 2019 have been recruited.All the recruited patients were subjected for comprehensive diagnostic evaluations according to the protocol of hospital routinely performed for all patients of stroke at our hospital.In short the clinical analysis of subtype were based on demographic characteristics,clinical features,risk factor profiles,neurological examinations and reports of diagnostic tests/brain imaging.Results:Among 352 patients,233(66.1%)are male patients and 119(33.8%)female patients.The mean age is 66.4 ± 12.6 y ears,with 30 and 89 years being the youngest and oldest respectively.The most common clinical symptoms was hemiparesis,observed in 215(61.07%)patients followed by difficulty in speech-171(48.5%)patients.SVO(Small vessel occlusion)-1 59(45.1%)is identified as the most common subtype of stroke followed by CE(Cardioembolism)-81(23.0%),LAA(large artery atherosclerosis)-65(18.7%),UDE(undetermined etiology)-38(10.8%)and ODE(other determined etiology)-9(2.56%)subtypes respectively.Hypertension is found to be the most prevalent risk factor at 67.8%(n=239).The highest prevalence of hypertension(75.3%)is prevalent in Large artery atherosclerosis(P<0.05).Diabetes mellitus(38.9%)is more prevelant in small vessel occlusion subtype(p=0.03).The frequency of stroke subtypes were more in the age group>65 years(n=203,57.6%)than the age group<65 years(n=149,42.3%)with the P value 0.01(P<0.05).Similarly,in gender comparision all the stroke subtypes are more prevalent in male gender than female.Thrombolytic therapy was done in 67/352(19.1%)patients being highest in cardioembolism stroke subtype(38.8%)with p value<0.01.Conclusion:Our results summarise the characteristics of ischemic stroke subtypes,assess its incidence rate and profound differences in its prevalence in clinical studies regarding various risk factors,imaging variables,age and gender distribution and treatment strategies.A higher prevalence of small vessel disease and cardioembolic disease whereas a lower prevalence of large vessel disease was observed.