Assessment of Stroke Patterns and Risk Factors in Northeast India: A Hospital-Based Prospective Study
Author(s)
RUBY KASANA, PhD1, SNEHA MARIAM BIJU, M. Pharm1, Amit Ranjan Barua, MD, DNB2, Mausumi Barthakur, MD, PhD2, Krishna Undela, PhD1.
1National Institute of Pharmaceutical Education and Research (NIPER) Guwahati, Guwahati, India, 2GNRC Institute of Medical Sciences, North Guwahati, India.
1National Institute of Pharmaceutical Education and Research (NIPER) Guwahati, Guwahati, India, 2GNRC Institute of Medical Sciences, North Guwahati, India.
OBJECTIVES: This study aimed to evaluate and compare the clinical characteristics and risk factors of hemorrhagic and ischemic stroke in Northeast India.
METHODS: A prospective observational study was conducted over six months (September 2023 to February 2024) at a multi specialty tertiary care hospital. Patients with new or recurrent strokes admitted to the neurology intensive critical care unit and confirmed by neuroimaging were included. Data were obtained through clinical evaluation, structured interviews, and review of patient records. Sociodemographic, clinical, and imaging data were analyzed using chi-square tests, t tests, and multivariate logistic regression to identify independent risk factors.
RESULTS: Among 356 stroke patients enrolled, 222 (62.4%) had hemorrhagic strokes, while 134 (37.6%) had ischemic strokes. Notably, 327 (92%) were hypertensive, and 158 (44.4%) sought delayed medical attention after symptom onset. Hemorrhagic stroke patients had more severe National Institutes of Health Stroke Scale scores (NIHSS) (p<0.001) and higher early mortality (n=33, (14.9%)) compared to ischemic stroke (n=10, (7.5%)). Risk factors such as hypertension, non-adherence to antihypertensives, smoking, alcohol consumption, and COVID-19 vaccination were associated with higher odds of hemorrhagic stroke. Advanced age, history of stroke, type 2 diabetes mellitus, atrial fibrillation, low high-density lipoprotein cholesterol levels, and hypertensive-diabetics were more linked to ischemic stroke (p<0.05).
CONCLUSIONS: This real-world study highlights a higher burden of hemorrhagic stroke in Northeast India, with modifiable risk factors such as hypertension and smoking playing a central role. The strong association with irregular antihypertensive use underscores the urgent need for targeted public health interventions to improve medication adherence and control risk factors. Region-specific strategies are essential to reduce stroke incidence and recurrence, and larger multicenter studies are warranted to validate these findings.
METHODS: A prospective observational study was conducted over six months (September 2023 to February 2024) at a multi specialty tertiary care hospital. Patients with new or recurrent strokes admitted to the neurology intensive critical care unit and confirmed by neuroimaging were included. Data were obtained through clinical evaluation, structured interviews, and review of patient records. Sociodemographic, clinical, and imaging data were analyzed using chi-square tests, t tests, and multivariate logistic regression to identify independent risk factors.
RESULTS: Among 356 stroke patients enrolled, 222 (62.4%) had hemorrhagic strokes, while 134 (37.6%) had ischemic strokes. Notably, 327 (92%) were hypertensive, and 158 (44.4%) sought delayed medical attention after symptom onset. Hemorrhagic stroke patients had more severe National Institutes of Health Stroke Scale scores (NIHSS) (p<0.001) and higher early mortality (n=33, (14.9%)) compared to ischemic stroke (n=10, (7.5%)). Risk factors such as hypertension, non-adherence to antihypertensives, smoking, alcohol consumption, and COVID-19 vaccination were associated with higher odds of hemorrhagic stroke. Advanced age, history of stroke, type 2 diabetes mellitus, atrial fibrillation, low high-density lipoprotein cholesterol levels, and hypertensive-diabetics were more linked to ischemic stroke (p<0.05).
CONCLUSIONS: This real-world study highlights a higher burden of hemorrhagic stroke in Northeast India, with modifiable risk factors such as hypertension and smoking playing a central role. The strong association with irregular antihypertensive use underscores the urgent need for targeted public health interventions to improve medication adherence and control risk factors. Region-specific strategies are essential to reduce stroke incidence and recurrence, and larger multicenter studies are warranted to validate these findings.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD14
Topic Subcategory
Data Protection, Integrity, & Quality Assurance
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)