Surveillance of stroke: WHO STEP-wise approach: A Chennai stroke unit report

Abstract

Stroke is potentially the most devastating consequence of vascular disease, causing long-term disability and placing high medical, emotional, and financial burdens on the patient. WHO STEPS stroke surveillance study, provided the framework for our study of stroke patients in Chennai. In our center, we followed only the STEP 1 study and only hospital-based stroke data were collected. STEP 2 and 3 involved study of strokes in the community. We found that 78% of our patients were in the 6th to 8th decades of life; 72% had hypertension, either alone or in combination with other risk factors; 4 weeks after the stroke, 51% of our patients were independent with regard to mobility and the activities of daily living, while 14% had severe disability. We found a mortality rate of 14%. We concluded that the incidence of stroke in the community can be decreased further by effective risk factor modification. The admission delay needs to be shortened from> 48 h to less than 6 h. Our data also gave us fresh information about the recovery of motor function in stroke survivors at 28 days after the stroke.

Keywords

• Disability
• modified Rankin scale
• NIH scale
• risk factor
• stroke surveillance
• TOAST