Prospective Observational Comparison of Demographic Characteristics, Vascular Risk Factors, Neurological Severity, and In-Hospital Outcomes Between Adult Patients With Acute Ischemic and Hemorrhagic Stroke.

Background Stroke is a leading cause of morbidity and mortality. Acute ischemic and hemorrhagic stroke differ in their demographic characteristics, vascular risk factor profiles, clinical presentation, neurological severity, and short-term outcomes. This study aimed to compare the demographic characteristics, vascular risk factors, clinical presentation, neurological severity, and in-hospital outcomes of adult patients presenting with acute ischemic and hemorrhagic stroke. Methodology This hospital-based, prospective, observational study was conducted at Fauji Foundation Hospital, Rawalpindi, from April 2024 to March 2025. A total of 240 adult patients with acute stroke presenting within 72 hours of symptom onset were enrolled. Stroke subtype was confirmed by neuroimaging using computed tomography and/or magnetic resonance imaging. Demographic characteristics, vascular risk factors, clinical features, neurological severity, and in-hospital outcomes were recorded using a standardized data collection proforma. Data were analyzed using SPSS version 26. Frequencies and percentages were calculated for categorical variables, while mean ± standard deviation was used for continuous variables. Normality of continuous variables was assessed before applying the independent-samples t-test. Comparisons between ischemic and hemorrhagic stroke groups were performed using the chi-square test and independent-samples t-test, as appropriate. A p-value <0.05 was considered statistically significant. Results Among the 240 patients included, 168 (70.0%) had ischemic stroke, and 72 (30.0%) had hemorrhagic stroke. Hypertension was more frequent among patients with hemorrhagic stroke (60/72, 83.3%) than ischemic stroke (120/168, 71.4%), whereas diabetes mellitus (88/168, 52.4% vs. 20/72, 27.8%) and dyslipidemia (70/168, 41.7% vs. 16/72, 22.2%) were more common among patients with ischemic stroke. Compared with ischemic stroke, patients with hemorrhagic stroke had significantly higher mean systolic blood pressure (178.8 ± 23.7 vs. 156.4 ± 18.3 mmHg), lower Glasgow Coma Scale scores (9.4 ± 3.1 vs. 13.0 ± 2.2), longer hospital stay (9.6 ± 4.1 vs. 7.0 ± 2.8 days), a higher proportion with severe neurological deficits (34/72, 47.2% vs. 32/168, 19.1%), and greater in-hospital mortality (12/72, 16.7% vs. 14/168, 8.3%). Chi-square and independent-samples t-tests demonstrated significant differences between ischemic and hemorrhagic stroke with respect to age, sex, hypertension, diabetes mellitus, dyslipidemia, blood pressure, Glasgow Coma Scale score, hospital stay, neurological severity, and in-hospital outcomes (all p < 0.05), whereas residence, smoking status, obesity, and previous stroke showed no significant between-group differences (p > 0.05). Conclusions Hemorrhagic stroke was associated with greater neurological severity, higher blood pressure, longer hospitalization, and poorer in-hospital outcomes than ischemic stroke, whereas diabetes mellitus and dyslipidemia were more frequently observed among patients with ischemic stroke. These findings reflect the relative frequency of selected risk factors within this study population and should not be interpreted as indicating that these factors are unimportant in the alternate stroke subtype or as a basis for differentiating stroke subtype in clinical practice. Prompt neuroimaging remains essential for accurate diagnosis and appropriate acute management.