Assessment of Stroke and Treatment Outcomes among Patients at Tertiary Care Hospital

Abstract

Objective: To evaluate in-hospital outcomes among patients with acute stroke and identify demographic, clinical, and laboratory factors associated with unfavourable outcomes at a tertiary care hospital in Multan, Pakistan.

Methodology: A hospital-based cross-sectional descriptive study was conducted in the Department of Medicine at a tertiary care hospital in Multan, Pakistan, over a six-month period. Adult patients (≥18 years) with a clinical and radiological diagnosis of acute stroke were consecutively enrolled, while patients with transient ischemic attack, traumatic intracranial hemorrhage, stroke mimics, incomplete records, or refusal to participate were excluded. Data on demographic characteristics, vascular risk factors, laboratory parameters, treatment received, and in-hospital outcomes were collected using a structured questionnaire and medical records. Data were analyzed using IBM SPSS Statistics version 23.0. Descriptive statistics, the independent-samples t-test, Chi-square test, and multivariable logistic regression were performed.

Result: A total of 289 stroke patients were included, with a mean age of 61.8 ± 13.5 years and 52.6% males. Unfavorable outcomes were more frequent among older patients and those with diabetes mellitus, hypertension, and ischemic heart disease. Multivariable logistic regression identified increasing age (AOR 1.42 per 10-year increase; 95% CI: 1.14–1.76; p=0.002), diabetes mellitus (AOR 1.74; 95% CI: 1.01–2.98; p=0.046), higher HbA1c (AOR 1.28 per 1% increase; 95% CI: 1.07–1.53; p=0.007), elevated LDL cholesterol (AOR 1.11 per 10 mg/dL increase; 95% CI: 1.03–1.19; p=0.004), and serum creatinine (AOR 2.08; 95% CI: 1.28–3.39; p=0.003) as independent predictors of unfavorable outcomes. Sex, hypertension, smoking, and family history were not significant predictors after adjustment.

Conclusion: Among patients admitted with acute stroke at a tertiary care hospital, advanced age, diabetes mellitus, poor glycemic control, elevated LDL cholesterol, and impaired renal function were associated with unfavourable in-hospital outcomes. These findings highlight the importance of early risk stratification and identification of modifiable metabolic and clinical factors associated with unfavourable short-term stroke outcomes.

Keywords: Cardiovascular risk factors, Coma, Diabetes mellitus, HbA1c, In-hospital outcome, Serum creatinine,