FREQUENCY AND FACTORS OF HEMORRHAGIC TRANSFORMATION IN PATIENTS WITH ISCHEMIC STROKE

Z AHMAD; H HASHIM; L AFREEN; M KHAN

doi:10.54112/pjicm.v5i01.48

Authors

Z AHMAD Department of Neurology, Fauji Foundation Hospital Rawalpindi, Pakistan
H HASHIM Department of Neurology, Fauji Foundation Hospital Rawalpindi, Pakistan
L AFREEN Department of Neurophysiotherapy, Foundation University Islamabad, Pakistan
M KHAN Department of Neurology, Fauji Foundation Hospital Rawalpindi, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i01.48

Keywords:

Hemorrhagic Transformation, Ischemic Stroke, Hypertension, Diabetes, Hyperlipidemia, Risk Factors, Intensive Care Unit, Parenchymal Hematoma

Abstract

Background: Hemorrhagic transformation (HT) is a serious complication of ischemic stroke that can significantly impact clinical outcomes. Identifying its frequency and associated risk factors is crucial for improving patient management and reducing morbidity and mortality. Understanding these risk factors may help in developing targeted preventive strategies and optimizing stroke treatment protocols. Objective: To determine the frequency of hemorrhagic transformation in ischemic stroke patients and to identify the associated risk factors contributing to its occurrence. Study Design: Prospective cohort study. Setting: The study was conducted in a hospital-based setting. Duration of Study: This study was carried out from 11 July 2024 to 11 January 2025. Methods: A total of 180 ischemic stroke patients were enrolled in the study. Demographic data, medical history, and risk factors—including hypertension, diabetes, hyperlipidemia, ischemic heart disease, and smoking—were recorded. The frequency of HT was assessed using imaging modalities. Patient characteristics such as age, gender, and ICU admission were also analyzed. Statistical analyses, including chi-square and logistic regression, were performed to determine significant risk factors for HT, with a significance level set at p ≤ 0.05. Results: Among the 180 ischemic stroke patients, 17 (9.4%) developed HT. The most prevalent risk factors in the HT group were hypertension (70.6%), diabetes (58.8%), hyperlipidemia (41.2%), ischemic heart disease (23.5%), and smoking (41.2%). An age-related trend was observed, with the highest incidence of HT occurring in the 61–80 years age group (58.8%). Additionally, patients with HT had a higher ICU admission rate (35.3%) compared to those without HT (8.0%). Conclusion: This study highlights a significant association between hypertension, diabetes, hyperlipidemia, ischemic heart disease, and smoking with the development of hemorrhagic transformation in ischemic stroke patients. Early detection and management of these risk factors are essential in mitigating HT risk and improving patient outcomes. Close monitoring and individualized treatment strategies should be prioritized, particularly for high-risk patients, to reduce the likelihood of severe HT complications.

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