A Prospective Observational Study of Etiology of Stroke and Its Risk Factors

Abstract

Background: Stroke remains a leading cause of mortality and long-term disability worldwide. Understanding the etiology and risk factors of stroke is crucial for developing effective prevention strategies. This study aimed to investigate the distribution of stroke subtypes and associated risk factors in a cohort of 156 patients.

Methodology: A prospective observational study was conducted on 156 consecutive stroke patients admitted to a tertiary care hospital between January 2023 and December 2023. Detailed clinical evaluations, neuroimaging (CT/MRI) and laboratory investigations were performed. Stroke subtypes were classified according to TOAST criteria for ischemic stroke and standard classifications for hemorrhagic stroke.

Results: Among the 156 patients, 78.2% (n=122) had ischemic stroke and 21.8% (n=34) had hemorrhagic stroke. Large-artery atherosclerosis (36.9%) was the most common etiology of ischemic stroke, followed by cardioembolic (24.6%), small-vessel occlusion (22.1%), stroke of other determined etiology (5.7%) and stroke of undetermined etiology (10.7%). Hypertension was the most prevalent risk factor (72.4%), followed by dyslipidemia (58.3%), diabetes mellitus (44.2%), smoking (32.1%), prior history of stroke/TIA (21.8%), atrial fibrillation (18.6%) and obesity (16.7%). Multiple logistic regression analysis revealed hypertension (OR 3.8, 95% CI 2.1-6.9), atrial fibrillation (OR 2.9, 95% CI 1.7-5.2) and smoking (OR 2.6, 95% CI 1.5-4.7) as independent predictors of stroke severity and poor outcomes.

Conclusion: This study confirms the high prevalence of modifiable risk factors in stroke patients with hypertension being the predominant factor. Understanding stroke etiology and risk factor profiles is essential for developing targeted prevention strategies and optimizing patient management. Early recognition and aggressive management of these modifiable risk factors could significantly reduce stroke burden.