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Stroke Scenario in India
DR SUDHIR KUMAR MD DM
CONSULTANT NEUROLOGIST
Apollo Hospitals, Hyderabad
Stroke is the 2nd most common killer amongst all Non-communicable diseases1
~15.4
Lakh
People2
Stroke can affect anyone at anytime
~6.3
Lakh3
Deaths every year because of stroke
~41%Patients do not survive stroke
In addition, ~64 Lakh life years are lost due to disability caused by stroke4
1. Strong, K., C. Mathers and R. Bonita (2007). "Preventing stroke: saving lives around the world." Lancet Neurol 6(2): 182-187.2. F Taylor and K Suresh Kumar. South Asia Network for Chronic disease, IIPH, Hyderabad, PHFI. 20123. World Health Organisation. Preventing Chronic Diseases: A vital investment. Geneva, Switzerland. 2005.4. World Health Organisation. Measurement in health. Statistics Tables 2009
STROKE EPIDEMIOLOGY
• Prevalence: 84-262/100,000 in rural areas, and 334-424/100,000 in urban areas (Pandianet al, J stroke, 2013)
• Incidence: 119-145/100,000 population
Journal of Stroke 2013;15(3):128-134
India Seems to have higher proportion of Hemorrhagic stroke cases than the west: 15-32 % as per various Indian Registries
28 day Case Fatality Rates due to stroke in India
Journal of Stroke 2013;15(3):128-134
Stroke Scenario – India
India
Population of India:1295 Mn2
Sources: 1. Journal of Stroke 2013;15(3):128-1342. Boehringer Ingelheim India – data on file
1648 2300 2975
5900
9200
12286
0
2000
4000
6000
8000
10000
12000
14000
2009 2010 2011 2014 2015 2016
AIS Patients Treated across India1,2
7TAMILNADU
2015 2016
1.000.65
KARNATAKA
2015 2016
1.150.91
MAHARASHTRA
& Goa
2015 2016
1.631.27
GUJARAT
2015 2016
0.850.70
AP & MP
2015 2016
0.580.44
East
2015 2016
0.120.06
U.P.
2015 2016
0.070.06
Comparison of Region
Wise Lysis Rates* in 2015
and 2016 (in %)
Source: Boehringer Ingelheim India – data on file
Extrapolated from Vial usage data in India
* - Denominator is all stroke patients
Delhi &
Haryana
2015 2016
3.46 4.68
KERALA
2015 2016
1.931.93 2.45
PUNJAB & HP
2015 2016
1.151.15 1.60
Quality parameters for stroke treatment in India: DTN* and lysis rates
• Lack of published data available
• The lysis rates have improved in the region from 0.69 % in 2014 to 1.06 % in 2015 and now in 2016, lysis rates are 1.23 %
• A tertiary center from India reported only 15 % of thrombolysed patients to have a DTN <60 minutes.
*- Door to Needle
Source: Boehringer Ingelheim India – data on fileIndian J Crit Care Med. 2015 May; 19(5): 265–269
Journey from 12200 40000.What are the possible gaps that could be addressed?
Targeted Awareness
Emergency / Casualty team coordination
Confident Stroke Physician
24X7 Diagnostic services
Inter departmental Flexibility
Stroke Team along with Stroke Unit
Public awareness
