scholarly journals COST EVALUATION OF STROKE THERAPY COMPARED TO INA-CBGs ON INPATIENTS AT ANUTAPURA HOSPITAL

2021 ◽  
Vol 16 (2) ◽  
pp. 285
Author(s):  
Muhamad Rinaldhi Tandah ◽  
Alwiyah Mukaddas ◽  
Dewi Angriani ◽  
Gaby Nathania Angela Mangoting
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Cost Evaluation ◽  
Stroke Therapy ◽  
Stroke Patients ◽  
Total Cost ◽  
Real Cost ◽  
Significant Difference ◽  
The Difference ◽  
The Cost

ABSTRACTStroke is the third cause of death in the world after heart disease, cancer, and disability including disability categorized based on its severity: mild (I), moderate (II), and severe (III) severity. This study aims to determine the difference total cost of ischemic and hemorrhagic stroke therapy, each, with INA-CBGs rates. The method of data collection was conducted retrospectively taken from medical record data, and on patient medical expenses. The subject were ischemic and hemorrhagic stroke patients hospitalized from 2016-2017 at Anutapura Hospital who met the inclusion and exclusion criteria. There were 134 patients who met the inclusion criteria, 68% were ischemic stroke patients and 32% were hemorrhagic stroke patients. The result of research showed that there were significant differences in costs (p <0.05) between hospital real costs and INA-CBGs rates. The average total real cost of treatment for ischemic stroke therapy was IDR 7,360,196.70 and the cost of the INA-CBGs was IDR 7,427,251.65 for 91 inpatients; and the average total cost of patients with hemorrhagic stroke therapy took IDR 10,606,834.34 with average of INA CBG’s rate at IDR 4,399,393.02 for 43 inpatients. The conclusion is both of stroke therapy proved significant difference compared to BPJS claimed amount of money.Keywords: pharmacoeconomic, cost analysis, ischemic stroke, haemorrhage stroke, INA-CBG’s rate.

Perbedaan Skor Functional Independence Measure (FIM) pada Pasien Rawat Inap dengan Stroke Iskemik dan Stroke Hemoragik di Rumah Sakit di Kota Bengkulu Tahun 2018

2018 ◽  
Vol 1 (3) ◽  
pp. 163-175
Author(s):  
Panji Harry Priya Nugraha ◽  
Suryo Bantolo ◽  
Annelin Kurniati ◽  
Noor Diah Erlinawati ◽  
Ahmad Azmi Nasution
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Functional Independence Measure ◽  
Total Sample ◽  
Functional Independence ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Significant Difference ◽  
Score Gain ◽  
The Difference

Stroke is one of the most common causes of disability in the world. Patients with ischemic stroke have different functional improvements from patients with hemorrhagic stroke. The tool is the Functional Independence Measure (FIM) questionnaire. This study aims to determine the difference in FIM scores in hospitalized patients with ischemic stroke and hemorrhagic stroke at hospitals in Bengkulu City. This research is an observational analytic research with cross-sectional design. The study involved stroke patients who hospitalized at RS Bhayangkara Bengkulu City, RSUD Bengkulu City, and RSUD dr. M. Yunus Bengkulu City from January-April 2018 with total sample 22 ischemic stroke patients and 22 hemorrhagic stroke patients who met the inclusion criteria. FIM scores as independent variables, while the type of stroke as dependent variables. The difference between the two variables was analyzed by unpaired t test and Mann-Whitney test. Patients with ischemic stroke had admission FIM score higher than patients with hemorrhagic stroke (26 vs 13,5; p=0.006). There were no differences in discharge FIM score in patients in both types of stroke (1,67 vs 1,58; p=0,081). There was no difference in FIM score gain between patients with ischemic stroke and patients with hemorrhagic stroke (4,12 vs 4,36; p=0,444). Patients with ischemic stroke had higher admission FIM score compared to patients with hemorrhagic stroke, but there was no significant difference in FIM score gain during hospitalization between ischemic stroke and hemorrhagic stroke patients at hospitals in Bengkulu City.

scholarly journals Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients

2020 ◽  
Vol 1 (2) ◽  
pp. 49
Author(s):  
Hijriyah Putri Tarmizi Hasibuan ◽  
Isra Thristy
Keyword(s):  
Ischemic Stroke ◽  
Total Cholesterol ◽  
Large Scale ◽  
Hemorrhagic Stroke ◽  
Total Cholesterol Level ◽  
Haemorrhagic Stroke ◽  
Total Sample ◽  
Stroke Patients ◽  
Average Value ◽  
Significant Difference

Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.

scholarly journals ELECTROLYTE DISTURBANCE IN HEMORRHAGIC AND NON-HEMORRHAGIC STROKE PATIENTS IN AL-DIWANIYAH TEACHING HOSPITAL

2018 ◽  
Vol 11 (11) ◽  
pp. 456
Author(s):  
Aqeel Raheem Hassan ◽  
Zahraa Adel Aryan
Keyword(s):  
Ischemic Stroke ◽  
Teaching Hospital ◽  
Serum Potassium ◽  
Sodium Level ◽  
Hemorrhagic Stroke ◽  
Control Group ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Electrolyte Disturbance ◽  
Significant Difference

Objectives: Although there are many studies on stroke, few studies on electrolyte disturbance have been done in our country, even on the outside. Our aim in this study is to estimate the level of serum potassium and sodium in acute stroke patients with comparison to patients of the control group.Methods: Our study is a comparative cross-sectional study conducted on patients in the neurological center who suffer from stroke and others in medicine department admitted for any disease other than cerebrovascular accidents (CVA) they consider the control group. All were in AL-Diwaniyah Teaching Hospital from April to July 2018. The level of potassium and sodium from all patients is estimated. Patients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA) were classified into having Glasgow coma scores (GCS) of 3–8, 9–12, and 13–15, respectively.Result: Significant difference was seen in the distribution of patients according to GCS levels (p=0.014). Mean serum sodium was significantly lowest in hemorrhagic stroke, then ischemic stroke, followed by TIA, and the highest sodium level was seen in the control group (p<0.001). Mean serum potassium was significantly lowest in hemorrhagic stroke, then ischemic stroke, followed by TIA, and the highest sodium level was seen in the control group (p<0.001). Mean serum-to-potassium ratio was significantly highest in hemorrhagic stroke, then TIA, followed by ischemic stroke, and finally, by control group (p<0.001).Conclusion: This study reveals that, in hemorrhagic stroke, the incidence of electrolytes imbalance was more than ischemic and which was mostly hyponatremia and hypokalemia.

scholarly journals Association of the APOE, MTHFR and ACE genes polymorphisms and stroke in Zambian patients

2013 ◽  
Vol 5 (4) ◽  
pp. 20 ◽  
Author(s):  
Masharip Atadzhanov ◽  
Mwila H. Mwaba ◽  
Patrice N. Mukomena ◽  
Shabir Lakhi ◽  
Sruti Rayaprolu ◽  
...  
Keyword(s):  
Genetic Variation ◽  
Ischemic Stroke ◽  
Genetic Variants ◽  
Hemorrhagic Stroke ◽  
The Other ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Increased Risk ◽  
Apoe Locus ◽  
The Difference

The aim of the present study was to investigate the association of <em>APOE</em>, <em>MTHFR</em> and <em>ACE</em> polymorphisms with stroke in the Zambian population. We analyzed 41 stroke patients and 116 control subjects all of Zambian origin for associations between the genotype of the <em>APOE</em>, <em>MTHFR</em> and <em>ACE</em> polymorphisms and stroke. The <em>APOE</em> ε2ε4 genotype showed increased risk for hemorrhagic stroke (P&lt;0.05) and also a high risk for ischemic stroke (P=0.05). There was complete absence of the <em>APOE</em> ε2ε2 and the <em>MTHFR</em> TT genotypes in the Zambian population. The difference between cases and controls was not significant for the other genetic variants when analyzed for relationship between stroke, stroke subtype and genotype. We show that genetic variation at the <em>APOE locus</em> affects susceptibility to stroke. No detectable association were observed for the <em>MTHFR</em> and <em>ACE</em> genotypes and stroke in the Zambian population.

scholarly journals Cost of Illness Analysis and Quality of Life in Ischemic Stroke Patients In Usu Medan Hospital

2020 ◽  
Vol 8 (2) ◽  
pp. 1-6
Author(s):  
Darma Ericson Saragih ◽  
Azizah Nasution ◽  
Khairunnisa K
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Average Cost ◽  
Stroke Patients ◽  
Cost Rate ◽  
The Difference ◽  
Average Cost Rate ◽  
The Cost ◽  
Total Average Cost

Objective: aims to evaluate the COI INA-CBG BPJS patients hospitalized for ischemic stroke BPJS (n = 33) at USU Medan Hospital in February 2019-August 2019 period. Design: this study was conducted used a prospective cohort study method in patients with ischemic stroke (n = 33) in USU Hospital. Interventions: the intervened  variable were the cost of patient therapy and calculating the difference in claims of INA-CBGs with the cost of patient therapy. Main outcome measures: the main measurement in this study was quality of life with European Quality of Life - 5 Dimensions Three Level (EQ5D3L). Results:  the results of this study indicate the total average cost of ischemic stroke inpatient therapy at the In patient Installation of USU Hospital in Medan obtained Rp 2,284,854 The average cost / rate incurred by the Hospital for ischemic stroke patients (n = 33) is still below the INA-CBGs claim rate. There was a relationship between the quality of life of ischemic stroke patients with diagnosis and comorbidities of patients (p = 0.004). The average quality of life (QoL) of ischemic stroke patients was obtained 0.7324 ± 0.2118. Conclusion: it could be concluded that the quality of life of ischemic stroke patients is classified as good 32 patients (96.96%).    

scholarly journals Stroke Type, Etiology, Clinical Features and Prognosis of Diabetic Patients in Southern China

2020 ◽  
Vol 26 ◽  
pp. 107602962097309
Author(s):  
Ting Yang ◽  
Kai Fan ◽  
Yungang Cao ◽  
Jueyue Yan ◽  
Zhao Han
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Clinical Features ◽  
Hemorrhagic Stroke ◽  
Southern China ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Significant Difference

To analyze the type, etiology, clinical features and prognosis of stroke in southern China diabetic patients. From January to August 2019, acute stroke patients were prospectively enrolled in the Wenzhou Stroke Registry within 7 days of admission to the Hospital. The differences between the 2 groups of stroke patients with or without diabetes were in the following aspects: bleeding site of hemorrhagic stroke, different ischemic stroke etiology, Oxfordshire Community Stroke Project (OCSP) classification, death and disability within 3 months. Of the 497 patients enrolled, 104 (20.9%) were diabetic patients. 114(22.9%) patients had hemorrhagic stroke. The incidence of hemorrhagic stroke in the diabetic group was 10.6%, deep hemorrhage stroke account for 90.9%.In patients with ischemic stroke, the proportions of the new Trial of Org 10172 in Acute Stroke Treatment (TOAST) etiological subtype classifications (atherothrombosis (AT), cardioembolism (CE), small artery disease (SAD), stroke of other determined etiology (SOD) and stroke of undetermined etiology (SUD)) in the diabetic (non-diabetic) group was 43% (31%), 7.5% (14.1%), 27.9% (16.9%), 1% (0.3%), and 20.4% (37.6%), respectively; the proportion of The OCSP classifications(total anterior circulation infarcts(TACI), partial anterior circulation infarcts(PACI), lacunar infarcts(LACI) and posterior circulation infarcts(POCI)) in the diabetic (non-diabetic) group was16.1% (22%), 30.1%(37.2%), 42% (31.4%), and 10.8% (9%), respectively. The 3-month poor prognosis of the diabetic and non-diabetic groups was 23.1% and 28.2%. For diabetic patients, the incidence of hemorrhagic stroke is low, deep hemorrhage is common; SAD and LACI are common in the ischemic stroke; There was no significant difference in the 3-month prognosis between the 2 groups.

scholarly journals Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients

2020 ◽  
Vol 1 (2) ◽  
pp. 7
Author(s):  
Hijriyah Putri Tarmizi Hasibuan ◽  
Isra Thristy
Keyword(s):  
Ischemic Stroke ◽  
Total Cholesterol ◽  
Large Scale ◽  
Hemorrhagic Stroke ◽  
Total Cholesterol Level ◽  
Haemorrhagic Stroke ◽  
Total Sample ◽  
Stroke Patients ◽  
Average Value ◽  
Significant Difference

Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.

Diagnosis of cerebral hemorrhage before the era of computed tomography

2013 ◽  
Vol 154 (44) ◽  
pp. 1743-1746
Author(s):  
Gergely Hofgárt ◽  
Rita Szepesi ◽  
Bertalan Vámosi ◽  
László Csiba
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Hemorrhagic Stroke ◽  
Cranial Computed Tomography ◽  
Cerebral Stroke ◽  
Daily Routine ◽  
Stroke Patients ◽  
The Difference

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.

scholarly journals How big is the difference between marginal cost versus total cost estimates? the case of ischemic stroke in south carolina (SC)

2013 ◽  
Vol 16 (3) ◽  
pp. A281
Author(s):  
A.N. Simpson ◽  
H.S. Bonilha ◽  
A.S. Kazley ◽  
J.S. Zoller ◽  
C. Ellis
Keyword(s):  
South Carolina ◽  
Ischemic Stroke ◽  
Marginal Cost ◽  
Cost Estimates ◽  
Total Cost ◽  
The Difference

Abstract 176: Long Term Mortality in Acute Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation According to Location and Burden of Cerebral Microbleeds

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tae-Jin Song ◽  
Jinkwon Kim ◽  
Dongbeom Song ◽  
Yong-Jae Kim ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Independent Predictor ◽  
Stroke Patients ◽  
Risk Of Death ◽  
Long Term Mortality

Background: Cerebral microbleeds (CMBs) were predictive of mortality in elderly and considered as a putative marker for risk of intracranial hemorrhage. Stroke patients with non valvular atrial fibrillation (NVAF) require anticoagulation, which increases the risk of hemorrhages. We investigated association of CMBs with the long term mortality in acute ischemic stroke patients with NVAF. Methods: During 6 years , consecutive ischemic stroke patients who had NVAF and who had undergone brain MRI with a gradient-recalled echo sequence were enrolled. Long-term mortality and causes of death were identified using data from Korean National Statistical Office. Survival analysis was performed whether the presence, number and location of CMBs were related with all causes, cardiovascular, and cerebrovascular mortality during follow-up. Results: Total 506 patients were enrolled during the study period and were followed up for median 2.5 years. CMBs were found in 30.8% of patients (156/506). Oral anticoagulation with warfarin was prescribed at discharge in 477 (82.7%) patients. During follow up, 177 (35%) patients died and cerebrovascular death was noted in 93 patients (81 ischemic stroke and 12 hemorrhagic stroke). After adjusting age, sex and significant variables in univariate analysis (p<0.1), multiple CMBs (≥5) were the independent predictor for all-cause, cardiovascular and ischemic stroke mortalities. The strictly lobar CMBs were associated with hemorrhagic stroke mortality in multivariate Cox regression analysis (HR 4.776, p=0.032) (Figure 1). Conclusions: Multiple CMBs were the independent predictor for the long term mortality in stroke patients with NVAF. Among them, patients with strictly lobar CMBs had a high risk of death due to hemorrhagic stroke. Our findings suggest that detection of CMBs in stroke patients with NVAF are of clinical relevance for predicting long term outcome and that particular concern is necessary in those with strictly lobar CMBs for their increased risk of death due to hemorrhagic stroke. Figure 1.

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