Abstract
Objective: To explore the demographic data, risk factors and patterns of stroke patients in a Malaysia district hospital.
Methodology: This observational study was conducted in a district hospital of Johor, Malaysia from July 2014 to December 2014. Risk factors, clinical characteristics, and details of the acute stroke were analysed.
Results: 143 patients were recruited with a mean age of 62±14 years old. 61.5% were male and 70.6% with the education level of primary school and below. The top three risk factors for stroke were hypertension (76.2%), diabetes (51.0%) and dyslipidemia (18.2%). CT brain showed infarction in 69 (48.3%) patients, 23 (16.1%) had haemorrhage, and normal in 50 (35%) patients. The median hospital arrival time was 13.6 hours (IQR: 13.5 hours) with 43 (30.1%) patients arrived hospital less than 4.5 hours. The median time of the door to CT scannin was 95 minutes (IQR: 132 minutes). The mean NIHSS score was 8.7. According to TOAST classification 82 (52.7%) patients had small-vessel occlusion disease while 28 (19.6%) patients were large artery disease.
Conclusion: With one-third of the patients arriving the hospital within 4.5 hours, the option of thrombolysis as the mainstay of treatment in acute ischemic stroke needs to be explored in a district hospital. Public awareness of signs and symptoms of stroke is important to promote the eligibility of thrombolysis therapy. Furthermore, optimisation of risk factors will play a role in reducing the incidence of stroke.

Key words: stroke, prevalence, Malaysia, district hospital cerebrovascular accident