Browsing by Author "Premadasa, H.M.S.D."

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Carotid artery stenosis in patients with ischaemic stroke in a tertiary care centre: Prevalence and associated factors
    (Ceylon College of Physicians, 2019) Ranawaka, U.K.; Mettananda, K.C.D.; Eshani, M.D.P.; Wettasinghe, L.M.; Somaratne, S.; Premadasa, H.M.S.D.; Sirigampola, C.; Upasena, A.; Sathkorala, W.; Pathmeswaran, A.
    OBJECTIVES: Data on the prevalence of carotid artery stenosis (CAS) among Sri Lankan stroke patients is limited. We sought to determine the prevalence and associated factors of significant CAS in patients with ischaemic stroke admitted to a Sri Lankan stroke unit. METHODS: We prospectively studied all stroke patients admitted to a stroke unit in a tertiary care hospital over a five-year period. Presence and degree of CAS was evaluated by doppler ultrasonography (US). Degree of CAS was classified as low {<50%), moderate (50-69%), significant (70-99%) or total occlusion (100%) according to NASCET criteria. Factors associated with significant CAS were identified by stepwise multiple logistic regression analysis. RESULTS: Out of 867 stroke patients studied, 704 (81.2%) had ischaemic strokes (59.7% male, mean age 59.0 ± 10.3 years), and 550 (78.1%) of them had carotid doppler data available. 528 (96.0%) had low degree stenosis, 12 (2.2%) had moderate stenosis, 7 (1.3%) had significant stenosis and 3 (0.5%) had total occlusion. Older age was associated with significant CAS (OR 1.14, p=0.011) on stepwise multiple logistic regression analysis. Sex, smoking, BMI, total cholesterol, LDL cholesterol, history of diabetes mellitus, hypertension, hyperlipidemia or ischemic heart disease, and premorbid aspirin or statin use were not associated with significant CAS. CONCLUSIONS: Significant CAS is seen in only 1.8% of Sri Lankan patients with ischaemic stroke at this tertiary care centre. These figures are much lower compared to Western data. Our findings have implications for the use of management approaches such as thrombectomy and carotid endarterectomy in Sri Lankan patients. ACKNOWLEDGEMENTS: EMDP and WLM were supported by a research grant from the National Stroke Association of Sri Lanka.
  • Thumbnail Image
    Item
    Spontaneous intracerebral haemorrhages from a Sri Lankan tertiary care center: 5-year data
    (Ceylon College of Physicians, 2021) Dep, W.D.C.; Deelaka, A.G.S.; Somaratne, K.G.S.K.; Meegahapola, H.; Premadasa, H.M.S.D.; Kurukulasuriya, S.A.F.; Mettananda, K.C.D.; Ranawaka, U.K.
    Introduction and Objectives Epidemiological data on spontaneous intracerebral haemorrhage (sICH) is limited from South Asia. We sought to describe epidemiology of sICH in a Sri Lankan cohort. Methods We studied all patients with stroke admitted to the Stroke Unit, Colombo North Teaching Hospital over five years. Data from sICH patients regarding treatment seeking delays, clinical char-jcteristics, risk factors, stroke severity and functional outcome were compared with ischa-mic stroke (IS) patients. Resists 984 patients (mean age 58.7 years; 62.1% males) were studied: sICH 15.0% (147 patients), IS 85.0%. sICH patients: mean age 58.0 years; 67.3% males. sICH patients presented to hospital earlier (<3h sICH 70.6%, IS 37.2%, p<0.001) and had more severe strokes (NIHSS>15) (sICH 21.3%, IS 12.2%; p<0.001). Hypertension was commoner in sICH group (sICH 72.6%, IS 63.5%; p=0.034), whereas diabetes (sICH 39.0%, IS 51.6%; p=0.005) and smoking (sICH 16.6%, IS 25.5%; p=0.021) were less common. Altered consciousness (sICH 30.3%, IS 18.3%; p=0.001), dysphagia (sICH 55.9%, IS 34.4%; p<0.001), bladder involvement (sICH 56.6%, IS 28.7%; p<0.001), and seizures (sICH 4.1%, IS 1.5%; p=0.029) were commoner among sICH patients. sICH patients had more severe disability on discharge (Barthel index 0-60: sICH 71.1%, IS 45.2%; p<0.001; modified Rankin scale (mRS) 3-6: sICH 76.7%, IS 52.1%; p<0.001). sICH location (lobar vs. deep) and presence of intraventricular haemorrhage was not associated with stroke severity. Lobar ICHs had more severe disability on discharge (Barthel index <60: p=0.037; mRS>3: p=0.020). On logistic regression, sICH was independently associated with early presentation to hospital (OR 1.79; p=0.039), and severe disability on discharge (Barthel index <60: OR 2.42, p=0.028; mRS>3: OR 2.70, p=0.012). Conclusions sICH patients sought medical attention early and had different clinical profiles, more severe strokes and more severe disabilities.