Introduction:Clinical characteristics to differentiate stroke subtype may be helpful to make sound decisionin managing blood pressure in clinically stroke patients. This is more important while en route patient to tertiary centre forneuroimaging facility and neurosciences services. The objective of this study is to determine the distinction between ischaemic and haemorrhagic stroke based on the clinical characteristics. Time of presentation was also calculated to determine the feasibility of thrombolytic therapy among stroke patients in Malaysia.
Methods:A cross-sectional observational study of all stroke patients presented to Hospital Kuala Lumpur from January 2005 to May 2005. All patients were subjected to brain CT. Clinical characteristics –age, gender, loss of consciousness (LOC), headache, vomiting, Glasgow coma scale (GCS), systolic blood pressure and diastolic blood pressure –were assessed. Time of presentation was also determined. Multiple logistic regression analyses with the stroke types as the outcome (ischaemic=1 vs haemorrhagic stroke=0) were performed.
Results:A total of 143 patients (88 male and 55 female) were included. The mean age for haemorrhagic stroke was 51.1 (± 14.9) years oldand mean age for ischaemic stroke was 56.8 (± 9.7) years old.Our logistic model shows five clinical characteristics were associated with types of stroke–age, GCS, sex, headache and LOC. Male (adj. OR 0.18, 95% CI 0.05-0.59), headache (adj.OR 0.16, 95% CI 0.06-0.47), LOC (adj.OR 0.20, 95% CI 0.06-0.66), age in years (adj OR 1.06, 95% CI 1.01-1.11) and GCS (adj.OR 1.44, 95% CI 1.14-1.82)wereall significant (p-value < 0.05) in our model. Only 4.9% patients presented less than 3 hours and most of them (64.3%) presented more than 6 hours.
Conclusion:Male patients, having LOCandheadache were the clinical characteristics predictive of lower chance of having ischaemic stroke. But, increasing age and higher GCS were more likely to associate with ischaemic stroke. BP in clinically stroke patients that have higher odds for haemorrhagic stroke should be lowered with a target of SBP ≥ 140mmHg. There was significant delayed of presentation for stroke patients. Many factors need to be improved to reduce the time of presentation in the future.