scholarly journals Effectiveness of multidisciplinary team as a new model of after stroke patients’ rehabilitation

2019 ◽  
pp. 5-14 ◽  
Author(s):  
GE Ivanova ◽  
EV Melnikova ◽  
AA Shmonin ◽  
EV Verbitskaya ◽  
AA Belkin ◽  
...  
Keyword(s):  
Hemorrhagic Stroke ◽  
Phase 1 ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Patient Centered ◽  
Number Of Patients ◽  
Rehabilitation System ◽  
Rehabilitation Model ◽  
Stage System ◽  
Multidisciplinary Model

Modern papers on treatment and rehabilitation of stroke patients describe the advantages and effectiveness of certain medical rehabilitation types, but these data are not enough to evaluate the efficiency of the whole rehabilitation system. The study was aimed to investigate the potential of the patient-centered problem-oriented multidisciplinary three-stage system for medical rehabilitation of stroke patients. Thestudyincluded 1021 patientsover 18 affected with ischemic or hemorrhagic stroke in the acute phase. All patients had a disability of admission at the time (but no persisting disability in their history). Two models of rehabilitation measures were compared in two consecutive phases of the study. The linear model of rehabilitation assistance was mainly implemented in phase 1, and the multidisciplinary model was implemented in phase 2. The patients’ condition was evaluated using the Modified Rankin Scale (mRS) at the end of rehabilitation. Comparison of the 1st and 2nd phase results demonstrated that the number of patients with mRS score 0–1 in the 2nd phase was lower by 18%. The proportion of patients with positive dynamics was significantly higher in the 2nd phase than in the 1st phase, (16 and 30% respectively). In the 2nd phase there were significantly more patients who demonstrated improvement by 1–4 (mRS score). Thus, the use of a multidisciplinary model provides a significant benefit compared with a linear rehabilitation model.

scholarly journals ANALYSIS OF THE STRUCTURE OF CEREBROVASCULAR DISEASES

2021 ◽  
pp. 129-138
Author(s):  
Леся Васильевна Чичановская ◽  
Ольга Николаевна Бахарева ◽  
Денис Викторович Ганзя ◽  
Станислав Александрович Бахарев
Keyword(s):  
Progressive Increase ◽  
Cerebrovascular Diseases ◽  
Medical Rehabilitation ◽  
Hospital Services ◽  
Stroke Patients ◽  
Medical Institutions ◽  
Rehabilitation System ◽  
Tver Region ◽  
Personnel Shortages ◽  
Organizational Problems

Рассматриваются вопросы анализа структуры системы реабилитации больных инсультом в Тверском регионе. Целью исследования является анализ структуры и оценка эффективности маршрутизации больных инсультами в Тверском регионе. Авторами проведен последовательный анализ развития системы медицинской реабилитации больных инсультом в зависимости от прогрессивного увеличения коечной мощности ЛПУ. Обосновано, что в связи с территориальной удаленностью, кадровым дефицитом в районах Тверского региона, отсутствием необходимого оборудования увеличение выделенных ТФОМС объемов СБО (случай больничного обслуживания) не приводит к увеличению доли профиля «нейрореабилитация». Научная новизна полученных результатов заключается в том, что выявленные организационные проблемы системы медицинской реабилитации в Тверской области позволят переформатировать процесс перспективного планирования развития системы медицинских учреждений, оказывающих помощь по данному профилю, что необходимо для повышения эффективности лечения, снижения заболеваемости и инвалидизации больных инсультом. The issues of analysis of the structure of the system of rehabilitation of stroke patients in the Tver region are considered. The purpose of the study is to analyze the structure and evaluate the effectiveness of routing stroke patients in the Tver region. The author conducted a consistent analysis of the development of the medical rehabilitation system for stroke patients depending on the progressive increase in the bed power of LPU. It is justified that due to the territorial remoteness, personnel shortages in the regions of the Tver region, the lack of necessary equipment, the increase in the allocated TFOMS volumes of SBO (case of hospital services) does not lead to an increase in the share of the “neurorehabilitation” profile. The scientific novelty of the results is that the identified organizational problems of the medical rehabilitation system in the Tver region will allow reformatting the process of prospective planning for the development of a system of medical institutions providing assistance in this profile, which is necessary to increase the effectiveness of treatment, reduce the incidence and disability of stroke patients.

scholarly journals The role of reference service in coordinating medical rehabilitation system in Tver region

2017 ◽  
Vol 16 (2) ◽  
pp. 32-35
Author(s):  
L. V. Chichanovskaya ◽  
O. N. Bahareva ◽  
M. V. Nazarov ◽  
G. E. Ivanova
Keyword(s):  
Cerebral Circulation ◽  
Call Center ◽  
Secondary Prophylaxis ◽  
Medical Rehabilitation ◽  
Rehabilitation System ◽  
Rehabilitation Model ◽  
Reference Service ◽  
The Russian Federation ◽  
Tver Region

Since 2010 the National project aimed at reducing cardiovascular mortality has been implemented in Tver region. Since 2014 the region has accepted the 3-stage medical rehabilitation model according to the order of the Ministry of Healthcare of the Russian Federation No. 1705 (on Medical Rehabilitation). To streamline patient routing, the Ministry of Healthcare of Tver region issued guidelines on routing patients with acute disorders of cerebral circulation. In the Regional Clinical Treatment and Rehabilitation Center, a call center has been established to coordinate primary and secondary prophylaxis of patients with acute disorders of cerebral circulation and their routing.

scholarly journals Impact of a Stay-at-Home Order on Stroke Admission, Subtype, and Metrics during the COVID-19 Pandemic

2020 ◽  
Vol 10 (3) ◽  
pp. 159-165
Author(s):  
Fnu Rameez ◽  
Philip McCarthy ◽  
Yao Cheng ◽  
Laurel M. Packard ◽  
Alan T. Davis ◽  
...  
Keyword(s):  
Hemorrhagic Stroke ◽  
Statistical Significance ◽  
Control Group ◽  
Study Group ◽  
Care Hospital ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Number Of Patients ◽  
The Impact ◽  
At Home

<b><i>Objective:</i></b> Our study aims to evaluate the impact of a stay-at-home order on stroke metrics during the 2019-novel coronavirus (COVID-19) pandemic. <b><i>Methods:</i></b> Data on baseline characteristics, stroke subtype, initial National Institutes of Health Stroke Scale (NIHSS) score, the time between last known well (LKW) to emergency department (ED) arrival, tissue plasminogen activator (tPA) administration, the involvement of large vessel occlusion (LVO), and whether mechanical thrombectomy (MT) was pursued in patients with acute stroke were extracted from 24 March to 23 April 2020 (the time period of a stay-at-home order was placed due to the COVID-19 pandemic as the study group) at a tertiary care hospital in West Michigan, USA, compared with data from 24 March to 23 April 2019 (control group). <b><i>Results:</i></b> Our study demonstrated a reduction in cases of acute ischemic stroke (AIS), although this did not reach statistical significance. However, there was an increase in hemorrhagic stroke (7.5% controls vs. 19.2% study group). The age of stroke patients was significantly younger during the period of the stay-at-home order compared to the control group. We identified a significant overall delay of ED arrivals from LKW in the study group. Additionally, an increased number of AIS patients with LVO in the study group (34.8%) was found compared to the control group (17.5%). A significantly increased number of patients received MT in the study group. Additionally, 11 patients were COVID-19 PCR-positive in the study group, 10 with AIS and only 1 with hemorrhagic stroke. Patients with COVID-19 had a high incidence of atrial fibrillation and hyperlipidemia. One AIS patient with COVID-19 rapidly developed cytotoxic edema with corresponding elevated inflammatory biomarkers. No statistical significance was noted when stroke subtype, LVO, and MT groups were compared. <b><i>Conclusions:</i></b> There was a trend of decreasing AIS admissions during the COVID-19 pandemic. There was also a significantly increased number of AIS patients with LVO who received MT, especially those with COVID-19. We conclude that cytokine storm resulting from SARS-CoV-2 infection might play a role in AIS patients with COVID-19.

Correction of functional constipation in patients with limited mobility after stroke

2019 ◽  
Vol 1 (6) ◽  
pp. 53-55
Author(s):  
M. S. Turchina ◽  
M. V. Bukreeva ◽  
L. Yu. Korolyova ◽  
Zh. E. Annenkova ◽  
L. G. Polyakov
Keyword(s):  
Quality Of Life ◽  
Chronic Constipation ◽  
Functional Constipation ◽  
Cerebrovascular Diseases ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Limited Mobility ◽  
Complete Restoration ◽  
The World

Currently, the problem of early rehabilitation of stroke patients is important, since in terms of the prevalence of cerebrovascular diseases and disability after suffering a stroke, Russia is one of the first places in the world. The complex of medical rehabilitation of such patients should provide for the early and most complete restoration of all body functions, patient education for lost skills, re-socialization of the patient and improvement of the quality of life. One of the factors contributing to a significant reduction in the quality of life after a stroke is the development of chronic constipation. The article reflects the modern methods of correction of chronic constipation in patients with limited mobility.

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.

KUALITAS HIDUP PASIEN STROKE DI POLIKLINIK RAWAT JALAN RUMAH SAKIT SWASTA YOGYAKARTA

2019 ◽  
Vol 7 (3) ◽  
pp. 232-237
Author(s):  
Hana Larasati ◽  
Theresia Titin Marlina
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Hemorrhagic Stroke ◽  
Poor Quality ◽  
Social Dimension ◽  
Stroke Patients ◽  
Sampling System ◽  
Post Stroke ◽  
Psychological Dimension

Background: stroke is a disorder of nervous system function that occurs suddenly and is caused by brain bleeding disorders that can affect the quality of life physical dimensions, social dimensions, psychological dimensions, environmental dimensions. Based on the result of Lumbu study (2015) the number of samples were 71 people collected data using the (WHOQOL-BREF). There were 56 people (78,9%) had the poor quality of life of post stroke. The mean of post-stroke quality of life domain was physical domain (45,27%), psychological domain (49,87%), social relations domain (48,15%) and environmental domain (50.01%). Objective: the purpose of the study was know the quality of life of the stroke patients in Outpatient Polyclinic of Private Hospital in Yogyakarta. Methods: used descriptive quantitative by using questionnaire test of purposive sampling system based on patients who have been affected of ischemic or hemorrhagic stroke before, number 30 respondents. Result: quality of life of stroke patient of medium physical dimension (67%), psychological dimension (71%), social dimension (67%), dimension good environment (63%). Conclusion: the quality of life of stroke patients of physical dimension, psychological dimension, and moderate social dimension, while the quality of life of stroke patients were good environmental dimension.   Keywords: Hemorrhagic stroke, ischemic stroke, quality of life

GAMBARAN ANGKA KEJADIAN STROKE AKIBAT HIPERTENSI DI INSTALASI REHABILITASI MEDIK BLU RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI – DESEMBER 2011

e-CliniC ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Ariesta Zubiah Ramadhini ◽  
L. S. Angliadi ◽  
Engeline Angliadi
Keyword(s):  
Descriptive Study ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Female Patients ◽  
Male Patients

Abstract: Stroke may cause a serious problem that leads to a disability or even mortality. The purpose is to determine such an incidence caused by hypertension at the Installation of Medical Rehabilitation RSUP Prof. dr. R. D. Kandou Manado based on the characteristic of age, gender and occupation. This research was taken at the Installation of Medical Rehabilitation RSUP Prof. R. D. Kandou Manado by using retrospective descriptive study method as well as examining 228 new cases of stroke patients that correlated with conclusion criteria. The result showed 8,3% patients at ≤44th years old, 33,3% patients at 45th – 54th years old, 32% patients at 55th – 64th years old, 20,25% patients at 65th – 74th years old, 6,1% patients at 75th – 84th years old. 53,1% male patients, 46,9% female patients. 33,3% retirement, 18% farmers, 18% government officers, 5,3% private employees, 2,2% drivers, 0,9% teachers and, 3,1% housewives. Keywords: incidence, hypertension, stroke   Abstrak: Stroke dapat menimbulkan masalah besar karena menyebabkan kecacatan dan kematian. Tujuan, mengetahui gambaran angka kejadian stroke akibat hipertensi di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado sesuai dengan karakteristik umur, jenis kelamin, dan jenis pekerjaan. Penelitian dilakukan di Instalasi Rehabilitasi Medik BLU RSUP Prof. dr. R. D. Kandou Manado, dilakukan secara retrospektif deskriptif dan didapatkan sampel sebanyak 228 data pasien kunjungan baru kasus stroke sesuai kriteria inklusi yang ditetapkan. Hasil penelitian, pasien stroke berumur ≤44 tahun 8,3%, berumur 45 – 54 tahun 33,3%, berumur 55 – 64 tahun 32%, berumur 65 – 74 tahun 20,25%, berumur 75 – 84 tahun 6,1%. Pasien stroke berjenis kelamin laki – laki 53,1%, perempuan 46,9%. Pasien stroke yang berstatus pekerjaan pensiunan 33,3%, petani 18%, PNS 18%, pegawai swasta 5,3%, supir 2,2%, guru 0,9%, IRT 3,1%. Kata Kunci: gambaran angka kejadian, hipertensi, stroke

scholarly journals Comorbidity index for predicting mortality at 6 months after reperfusion therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyo Suk Nam ◽  
Young Dae Kim ◽  
Joonsang Yoo ◽  
Hyungjong Park ◽  
Byung Moon Kim ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Area Under The Curve ◽  
Reperfusion Therapy ◽  
Good Prediction ◽  
Multivariate Logistic Regression ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Comorbidity Index ◽  
Using Data

AbstractThe eligibility of reperfusion therapy has been expanded to increase the number of patients. However, it remains unclear the reperfusion therapy will be beneficial in stroke patients with various comorbidities. We developed a reperfusion comorbidity index for predicting 6-month mortality in patients with acute stroke receiving reperfusion therapy. The 19 comorbidities included in the Charlson comorbidity index were adopted and modified. We developed a statistical model and it was validated using data from a prospective cohort. Among 1026 patients in the retrospective nationwide reperfusion therapy registry, 845 (82.3%) had at least one comorbidity. As the number of comorbidities increased, the likelihood of mortality within 6 months also increased (p < 0.001). Six out of the 19 comorbidities were included for developing the reperfusion comorbidity index on the basis of the odds ratios in the multivariate logistic regression analysis. This index showed good prediction of 6-month mortality in the retrospective cohort (area under the curve [AUC], 0.747; 95% CI, 0.704–0.790) and in 333 patients in the prospective cohort (AUC, 0.784; 95% CI, 0.709–0.859). Consideration of comorbidities might be helpful for the prediction of the 6-month mortality in patients with acute ischemic stroke who receive reperfusion therapy.

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