Stroke is a medical emergency. Treatment with thrombolytic agents should be started within 4.5 hours of symptom onset. The treatment facilities are improving in India, however, there is still a long way to go. The current presentation discusses about the stroke scenario in India.

1. Stroke Scenario in India
DR SUDHIR KUMAR MD DM
CONSULTANT NEUROLOGIST
Apollo Hospitals, Hyderabad

2. 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
Inaddition,~64Lakhlifeyears are lost dueto disability caused bystroke4
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. 2012
3. World Health Organisation. Preventing Chronic Diseases: A vital investment. Geneva, Switzerland. 2005.
4. World Health Organisation. Measurement in health. Statistics Tables 2009

3. STROKE EPIDEMIOLOGY
• Prevalence: 84-262/100,000 in rural areas,
and 334-424/100,000 in urban areas (Pandian
et al, J stroke, 2013)
• Incidence: 119-145/100,000 population

4. 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

5. 28 day Case Fatality Rates due to
stroke in India
Journal of Stroke 2013;15(3):128-134

6. Stroke Scenario – India
India
Population of India:1295 Mn2
Sources:
1. Journal of Stroke 2013;15(3):128-134
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

7. 7
TAMILNADU
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

8. 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 file
Indian J Crit Care Med. 2015 May; 19(5): 265–269

9. 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

10. Comments/queries?
drsudhirkumar@yahoo.com
THANKS