CLINICAL PROFILE AND PRESCRIPTION PATTERN IN ACUTE ISCHEMIC STROKE AT A TERTIARY CARE HOSPITAL

Background: Acute Ischemic Stroke (AIS) is a leading cause of mortality and disability worldwide, primarily caused by the obstruction of cerebral blood flow due to thrombotic or embolic occlusion. AIS require immediate medical intervention to minimize neurological damage and improve patient outcomes. In developing countries, stroke incidence is increasing due to lifestyle changes, aging populations and rising prevalence of hypertension and diabetes mellitus. However, disparities exist in stroke management due to variations in healthcare infrastructure, access to thrombolysis and adherence to treatment protocols. Several studies emphasize the importance of early intervention, particularly intravenous thrombolysis (IVT) within the golden window of 4.5 hours. Despite these advances, many patients fail to receive timely treatment due to delayed hospital arrival and lack of awareness. Identifying the clinical profile and prescription patterns of AIS patients can provide insights into existing gaps in stroke care and inform strategies to improve management and prognosis. Objective: This study aims to analyze the clinical profile and prescription patterns in acute ischemic stroke (AIS) patients. Specific objectives include: - Identifying demographic patterns and risk factors. - Evaluating thrombolysis and antiplatelet therapy use. - Assessing adherence to stroke management guidelines. - Examining prescription variations based on demographics, co morbidities, and stroke severity. - Determining timely hospital arrival for thrombolysis and influencing factors. - Providing recommendations to optimize AIS treatment and reduce care disparities. Methodology: Prospective observational study over six months at Max Care Sai Tirumala Hospital, Palnadu. Sample: 125 AIS patients (aged 25–90), including those with hypertension and diabetes. Excludes hemorrhagic stroke, mental disorders, pregnant, and lactating women. Data on demographics, clinical details, and therapy were collected from medical records. Analysis used Microsoft Excel and statistical software. Results Gender: Stroke was more common in males (62%) than females (38%). Age: Most affected age group: 66-70 years (17%), followed by 56-60 years (15%). Comorbidities: Hypertension (52%) was the leading risk factor; 33% had both hypertension and diabetes. Social History: 49% were non-smokers/non-alcoholics, 29% alcoholics, 13% both smokers & alcoholics, 9% smokers. GCS Scores: Patients categorized by consciousness levels at presentation. Golden Hour Arrival: Some arrived within 4.5 hours, impacting treatment. Thrombolysis: Evaluated tPA administration and recovery impact. Prescription Patterns: Aspirin & Clopidogrel were common; anticoagulants and statins used as needed. Conclusion: This study provides insights into AIS demographics, risk factors, treatment strategies, and prescription trends. Risk Factors: Hypertension and diabetes were the most common comorbidities. Stroke was more prevalent in males and older adults (66–70 years). Lifestyle factors like smoking and alcohol increased risk. Treatment & Prescription: Thrombolytics (tPA), antiplatelets (aspirin, clopidogrel), and early intervention within the golden hour improved outcomes. Adherence to stroke guidelines varied, affecting secondary prevention. Recovery & GCS Scores: Patients with moderate to severe impairment had poorer recovery, highlighting the need for timely rehabilitation. Implications: Early diagnosis, risk factor management, and adherence to treatment protocols can reduce stroke complications. Public awareness, faster hospital access, and standardized prescription practices are essential for optimizing stroke care.