Profile of stroke in Gizan, Kingdom of Saudi Arabia

OBJECTIVE: The epidemiological characteristics of stroke at different geographical locations in the Kingdom of Saudi Arabia (KSA) have not been fully investigated. Reports from some areas indicate that stroke is one of the major causes of morbidity and mortality in the population. The present study was carried out to determine the clinical profile of stroke, its subtypes and associated risk factors in Gizan Province, KSA.

METHODS: Data on consecutive patients with stroke admitted to King Fahd Central Hospital, Gizan, KSA over a 2-year period from January 1997 to December 1998, were retrospectively analyzed. Diagnosis was confirmed by computerized tomography of the brain. Etiologic and risk factors were identified by relevant clinical, laboratory and imaging investigations.

RESULTS: Two hundred and forty-one patients (146 males and 95 females; mean age 64.5) were hospitalized during the study period. The subtypes of stroke comprised cerebral infarction (65.6%); intracerebral hemorrhage (30.7%) and sub-arachnoid hemorrhage (3.7%). Coma and convulsions were more frequent among patients with hemorrhagic strokes compared to the subgroup with cerebral infarction. Major risk factors included hypertension (45.6%), heart diseases with or without atrial fibrillation (31.1%) and diabetes mellitus (22.8%). In 19 (7.9%) patients, no risk factor was found. In-hospital mortality occurred in 20.3% (49 of 241 patients), with no significant difference in the rates in the different subtypes.

CONCLUSION: The crude incidence (estimated as 15.9 per 100, 000) in Gizan, KSA, a largely rural area is lower than the reported rates in urban areas of KSA. However, intracerebral hemorrhage had a higher relative frequency, suggesting a geographic variation in the subtypes at different areas. The establishment of rehabilitation centers in the province will reduce the heavy burden on health services and relatives. The incidence and prevalence of stroke must be reduced by appropriate strategy with the objectives of preventing or modifying risk factors such as hypertension, diabetes mellitus and smoking. A national stroke registry should be strengthened to provide further information on the epidemiology of stroke in KSA.