Determinants of functional outcomes among non-diabetic stroke patients at a tertiary care hospital in pakistan: a one-year follow-up assessment

Purpose The aim of the study was to identify factors associated with one-year functional outcomes in non-diabetic stroke patients, with particular focus on age, echocardiographic findings, biochemical markers, and clinical risk factors. Echocardiographic findings were assessed from routine transthoracic echocardiography reports and included left ventricular systolic dysfunction, valvular disease, chamber enlargement, and intracardiac thrombus, where reported, and were classified as a binary variable (normal or abnormal) for statistical analysis. Methodology This observational, prospective, one-year follow-up study included 262 consenting non-diabetic stroke patients admitted to Fauji Foundation Hospital, Rawalpindi, Pakistan. Stroke diagnosis was confirmed by CT scan, and patients with HbA1c < 6.5% were included. Demographic details, biochemical parameters, comorbidities, and echocardiographic findings were recorded. Echocardiographic findings were categorized as normal or abnormal based on the interpretation of the reporting cardiologist. Functional outcome was assessed using the modified Rankin Scale (mRS). Data were analyzed using SPSS version 25. Statistical analyses included one-way ANOVA, t-test, and multiple linear regression. The analysis did not include detailed adjustment for stroke severity, stroke subtype or lesion characteristics, acute reperfusion treatment, or rehabilitation exposure, which may represent important sources of residual confounding. Results Abnormal echocardiographic findings were significantly associated with one-year functional outcomes in non-diabetic stroke patients. However, the multivariable model explained a modest proportion of outcome variance (R 2 = 0.171), indicating limited explanatory power and suggesting that echocardiographic abnormalities alone do not account for most of the variation in functional recovery. Age was also associated with poor recovery, with patients aged 60 to 79 years showing significantly worse functional outcomes. In contrast, routine biochemical markers, including HbA1c, lipid profile, and renal function tests, as well as gender and traditional vascular risk factors, did not independently predict one-year mRS outcomes. Length of hospital stay showed a trend toward significance. Post-hoc analysis showed that differences among risk-factor categories were not attributable to a single dominant factor. The age and risk-factor regression model also demonstrated low explanatory power (R 2 = 0.042), further indicating that the observed associations should be interpreted cautiously. Conclusion Abnormal echocardiographic findings and age were associated with one-year functional outcomes in this cohort, but the modest explained variance and the absence of adjustment for important clinical factors limit the strength of these associations. These findings should therefore be considered preliminary and hypothesis-generating rather than definitive predictors of recovery. Echocardiographic abnormalities may have potential value for clinical risk stratification, but their independent contribution to recovery requires further investigation. Further multicenter studies with larger samples and comprehensive adjustment for stroke severity, stroke characteristics, acute treatment, and rehabilitation exposure, together with appropriate ordinal-outcome modelling, are needed to confirm these findings.