STROKE PATIENTS

Stroke is one of the leading factors of morbidity and mortality worldwide. Toreduce the incidences of stroke, it is essential to identify and modify the risk factors for stroke.Risk factors can be modifiable and non modifiable. The aim of study was to ascertain theoutcome of stroke patient admitted in all Medical Wards in Liaquat University Hospital HyderabadObjective: To see the mortality, morbidity, disability and co-infection in stroke patients. StudyDesign: Prospective study. Period: One year. Setting: Medical Wards of Liaquat UniversityHospital Hyderabad / Jamshoro. Material and Methods: 200 Patients were enrolled in ourstudy to see the excepted outcome like mortality, Disability, Bed Sores, UTI & Pneumonia andDehydration in Stroke patients. All the patients were Young Adults, greater than 12 years inage and old aged patients, with Ischemic & Hemorrhagic stroke. On categorical variable suchas sex, mortality, morbidity chi-square test was applied at 95% confidence interval and the P-value ≤0.05 was considered as statically significant while the mean ±SD will be calculated forquantitative variables. Results: Mean age of the patient in our study was 57.03 years with thestandard deviation of ±7.35 years. Gender distribution shows most of the patients in our studywere male, i.e. 75% while, only 25% of the patients were female. Ischemic Stroke was foundin 126(63%) patients while, hemorrhagic stroke was found in 74(37%) patients. Regardingoutcome, mortality was found in 5% patients, disability 2%, UTI 2%, pneumonia 15%, Coinfection4%, Bed Sores 21.5% and dehydration was present in 50.5% patients. Conclusion:The study concludes that maximum patients had Ischemic Stroke. Among these patientsdehydration was the most common entity followed by bed Sores, pneumonia, mortality, Coinfection,disability and UTI.

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Hubungan Kerasionalan Peresepan Obat Antihipertensi Dengan Outcome Klinis Pada Pasien Stroke Iskemik Rawat Inap RSUD Dr. Soegiri Lamongan

Pharmacon Jurnal Farmasi Indonesia ◽

10.23917/pharmacon.v18i01.13230 ◽

2021 ◽

Vol 18 (1) ◽

pp. 47-59

Author(s):

Muhammad Muhlis ◽

Luthfiyya Iffa Muslimah

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Clinical Outcomes ◽

Antihypertensive Drugs ◽

P Value ◽

Stroke Patients ◽

Chi Square ◽

Cross Sectional ◽

Appropriate Treatment ◽

Chi Square Test

Ischemic stroke is a disruption of blood supply to the brain caused by the blockage of blood vessels. Hypertension is a comorbid disease in ischemic stroke. Appropriate treatment can affect the success of therapy and the achievement of the desired blood pressure. This study aims to evaluate the rationale for using antihypertensive drugs to achieve clinical outcomes in the form of blood pressure. This study was designed in an observational analytic manner with a cross-sectional approach, retrospective in nature with a purposive sampling method in ischemic stroke patients who received antihypertensive prescriptions in RSUD Dr. Soegiri Lamongan. The sample used was 100 patients. The results showed that the most widely used antihypertensive drugs were CCB with a percentage of 41.8%, ARB with a percentage of 27.6%. The rationale for prescribing was obtained: 100% correct indication, 100% correct patient, 91% correct drug, and 100% correct dose. The results of the Chi-Square test have obtained an expected value of 5, so that it is followed by the Fisher's Test, which obtained a p-value of 0.021 (p 0.05). The conclusion of this study is that patients who received a rational antihypertensive prescription were 91%, for patients who achieved clinical outcomes as much as 86% and there was a relationship between the rationality of prescribing antihypertensive drugs with clinical outcomes in the form of achieving target blood pressure in ischemic stroke patients at RSUD Dr. Soegiri Lamongan.

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Hubungan Dukungan Keluarga dengan Tingkat Harga Diri pada Penderita Stroke di Rumah Sakit Umum Royal Prima Medan

Jurnal Riset Hesti Medan Akper Kesdam I/BB Medan ◽

10.34008/jurhesti.v4i2.137 ◽

2020 ◽

Vol 4 (2) ◽

pp. 66

Author(s):

Yusmawarnita Zai ◽

Kandrinus Bu’ulolo ◽

Novy Fajariani ◽

Yasozatulo Hulu ◽

Ruslan Efendi Gulo ◽

...

Keyword(s):

Family Support ◽

Self Esteem ◽

Cross Sectional Study ◽

P Value ◽

Stroke Patients ◽

Chi Square ◽

Cross Sectional ◽

Study Approach ◽

Chi Square Test ◽

Relationship Of

Stroke is a condition where a part of the brain is suddenly disturbed which is caused by a lack of blood supply, which causes an inhibition of metabolic processes. As a result of a stroke affects the psychological function of the patient, so the patient feels his level of self-esteem decreases or is low. The role and support of families play an important role in the rehabilitation process to provide health services for stroke patients. The aim is to find out the relationship of family support with the level of self esteem (self-esteem) in stroke patients at the Royal Prima Medan Hospital in 2019. The design used a "cross sectional study" approach with a population of 2,690 people. Samples were stroke patients at RSU Royal Prima medan, as many as 25 respondents using accidental sampling techniques and questionnaires as research instruments. The test used is the chi-square test. The results of the study Based on the chi-square test found p value (<0.05) statistically shows that there is a relationship between family support and the level of self esteem (self-esteem) in stroke patients specifically there is a relationship between informational support (p-value = 0.009), assessment support (p-value = 0.003), Instrumental support is obtained (p-value = 0.009), Emotional support (p-value = 0.004) with the level of self esteem (self-esteem) in stroke patients. This research shows that good family support will positively impact the level of self esteem (self-esteem) in stroke patients.

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HUBUNGAN PENINGKATAN KADAR LDL KOLESTEROL PADA PASIEN STROKE ISKEMIK DI RUMAH SAKIT UMUM HAJI MEDAN

Jurnal Penelitian Kesmasy ◽

10.36656/jpksy.v1i2.179 ◽

2019 ◽

Vol 1 (2) ◽

pp. 104-109

Author(s):

Zaim Anshari

Keyword(s):

Ischemic Stroke ◽

General Hospital ◽

Medical Records ◽

Ldl Cholesterol ◽

Stroke Patients ◽

Chi Square ◽

Inconsistent Result ◽

Chi Square Test ◽

High Level ◽

Test Result

Introduction: The causes of ischemic stroke by the high level of ldl cholesterol is still uncertain or can not be confirmed yet. The researches regarding the correlation of the high level of ldl cholestrol on the ischemic stroke patients only in small numbers with inconsistent result. Purpose: to know the correlation of high level of idl cholestrol on ischemic stroke patients. Method: this research is an analytic research by using restrospective study method on ischemic stroke patients whom hospitalized in Haji Medan General Hospital period January to Maret 2019. The datas were taken from patient medical records. Those datas will be analyzed by using chi square test. Result: there were 40 subjects whom are in ages of 61-70 years old. There was no correlation of high level of ldl cholestrol on ischemic stroke patients (p=0.943) which means (p>0.05) H○ is unaccepted. Discussion: there is no correlation of high level of ldl cholestrol on ischenic stroke patients

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Correlation of blood glucose levels, HbA1c, hemoglobin and leukocytes with outcome on acute stroke

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191629 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1430

Author(s):

Meiriani . ◽

Yuneldi Anwar ◽

Puji Pinta Omas Sinurat

Keyword(s):

Ischemic Stroke ◽

Blood Glucose ◽

Acute Stroke ◽

Hemorrhagic Stroke ◽

Cross Sectional Study ◽

P Value ◽

Stroke Patients ◽

Cross Sectional ◽

Glucose Levels ◽

Blood Glucose Levels

Background: Diabetes and higher HbA1c level have increased the incidence of stroke. Hemoglobin levels both high and low are associated with poor outcomes. Leukocytes play an important role in the initiation of the atherosclerosis process.Methods: This was a cross-sectional study with a sample size of 62 people selected by non-random sampling method on a consecutive basis, patients with acute stroke were taken blood to measure blood glucose levels, HbA1c, Hb and Leucocytes when entering the hospital room. Outcomes were assessed using NIHSS and MRS. The calculation of NIHSS and MRS scores was performed on the first day of admission and the fourteenth day. To analyze the correlation of blood sugar levels during HbA1c, Hb and leukocytes in acute stroke, this study used Spearman's correlation test. The p value <0.05 was considered statistically significant.Results: The study subjects of 62 acute stroke patients (acute ischemic stroke 31 people and 31 people hemorrhagic stroke). Acute stroke patients were consisted of 38 men (61.3%) and 24 women (38.7%). Of 31 people with hemorrhagic stroke, there were 16 men (51.6%) and 15 women (48.4%), ischemic stroke patients were consisted of 22 people (71, 0%) and women were 9 people. Spearrman repair test showed no symptoms between blood glucose levels, HbA1c, Hemoglobin and leukocytes with outcomes in acute stroke.Conclusions: There was no significant association between blood glucose levels, HbA1c, hemoglobin and leukocytes with outcomes in acute stroke.

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HUBUNGAN PENINGKATAN KADAR LDL KOLESTEROL PADA PASIEN STROKE ISKEMIK DI RUMAH SAKIT UMUM HAJI MEDAN

Jurnal Penelitian Kesmasy ◽

10.36656/jpksy.v1i2.149 ◽

2019 ◽

Vol 1 (2) ◽

pp. 104-109

Author(s):

Zaim Anshari

Keyword(s):

Ischemic Stroke ◽

General Hospital ◽

Medical Records ◽

Ldl Cholesterol ◽

Stroke Patients ◽

Chi Square ◽

Inconsistent Result ◽

Chi Square Test ◽

High Level ◽

Test Result

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HUBUNGAN PELAKSANAAN SCREENING TEST MENELAN DENGAN KEJADIAN DISFAGIA PADA PASIEN BARU YANG MENDERITA STROKE AKUT

JURNAL KESEHATAN PERINTIS (Perintis's Health Journal) ◽

10.33653/jkp.v4i2.230 ◽

2017 ◽

Vol 4 (2) ◽

pp. 47-53

Author(s):

Muhammad Arif

Keyword(s):

Acute Stroke ◽

Screening Test ◽

P Value ◽

Stroke Patients ◽

Test Procedures ◽

Chi Square ◽

Chi Square Test ◽

Relationship Of ◽

The Relationship ◽

Test Result

According to the NINDS 2015, States that a stroke occurs when the blood supply to brain fails suddenly interrupted due to a blockage or rupture of blood vessels were. Basic Health Research results that show an increase in the prevalence of stroke symptoms in Indonesia increased from 8.3 at 1000 in 2007 to 12.1 and at 1000 in 2013. One of the problems that arise due to stroke is a disorder of swallowing or dysphagia. According to the World Stroke Academy Learning Moduls in 2012 the prevalence of dysphagia in stroke sufferers range from 36 to 67%. In the year 2016 in RSSN dysphagia in stroke patients 22,94%. For early detection of dysphagia screening test required to swallow as a first step in identifying the risks due to dysphagia and aspiration in stroke patients. The purpose of this research is to know the relationship of the implementation of the screening test to swallow with dysphagia in acute stroke patients in the room just entered inpatient Neurology RSSN Bukittinggi in 2017. This research method using analytic, descriptive, then the data was processed using the Chi Square test. The sample in this study as many as 54 people respondents. Test result statistics retrieved value p value = 0.002 (p < α) then it can be inferred the existence of a relationship between the implementation of the screening test to swallow with dysphagia in acute stroke patients the new entry. Analysis of the results obtained OR = 9.281 meaning respondents who perform screening test procedures in accordance with the swallow has a chance of 9.281 times in detecting the occurrence of dysphagia. Suggestions in this study is the implementation of a screening test this swallow can be included in SPO for nurses in Bukittinggi in the room especially RSSN Neurology in detecting the onset of dysphagia in acute stroke patients.

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Abstract P265: Identifying Factors Associated With Early Transfer Death of Stroke Patients Can Improve Transfer Criteria

Stroke ◽

10.1161/str.52.suppl_1.p265 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Randi R Toumbs ◽

Thanh Dao ◽

Liang Zhu ◽

Sean I Savitz

Keyword(s):

Hospital Mortality ◽

High Mortality ◽

Financial Burden ◽

Early Death ◽

University Hospital ◽

Stroke Patients ◽

Chi Square ◽

Exact Test ◽

Chi Square Test ◽

Ich Score

Introduction: Mortality is an important performance metric monitored by CMS, US News and World Report, and Vizient UHC. Large academic medical centers have high mortality given higher severity of disease and volume. We analyzed mortality of stroke patients transferred to our university hospital from community EDs. Transferring patients who die within 48 hours raises questions about resources, financial burden, and unrealistic expectations from families. We analyzed our transfer early death (TED) population to improve identification of patients who likely do not benefit from transfer out of a community hospital. Methods: Patients with DRG codes for ischemic and hemorrhagic strokes admitted from July 2018-June 2020 were identified. Transfer patients were isolated and grouped as outside hospital (OSH) or intra-system transfers. Data were analyzed for overall hospital mortality and TED mortalities and characteristics. Demographic and clinic variables were compared between intra-system and outside transfers by chi-square test, Fisher’s exact test, t test or Wilcoxon rank sum test. Results: The total stroke mortality rate was 13% with 276 deaths out of 2,145 patients. There were 171 early deaths out of 276 deaths (62%). There were a total of 923 transfer patients in the 2-year period; 76 were TED (8%) and TED accounted for 27% of all in-hospital mortality at our center. Median age of TED was 67, median NIHSS was 27, 39% were >70, and 80% were ICH with a median ICH score 4. The mean volume of ICH was 68mL (SD=55.2). There were no significant associations between age, sex and ethnicity with TED compared with patients who survived beyond 48 hrs. Among TED, 31 (41%) were from within our health system and 45 (59%) were OHS transfers. There were no significant differences among stroke type, severity (GCS, NIHSS, ICH score, MRS), or demographics between intra-system and OSH transfers. Conclusions: TED patients are more likely to have severe ICH where medical care may be futile. Strategies are needed to work with community hospitals to establish goals of care and implement approaches to provide end-of-life services at these facilities. Identification and implementation of such strategies may also reduce intra-system transfers of patients with high mortality.

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219. Is the modified quick SOFA scale superior to quick SOFA in patients with diagnosed septic shock?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.294 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S128-S128

Author(s):

Deniz Akyol ◽

Ayşe Uyan Önal ◽

Uğur Önal ◽

Damla Akdağ ◽

Cansu Bulut Avşar ◽

...

Keyword(s):

Septic Shock ◽

Survival Rate ◽

Tertiary Care ◽

University Hospital ◽

P Value ◽

Chi Square ◽

Number Of Patients ◽

Significant Difference ◽

Chi Square Test ◽

Qsofa Score

Abstract Background In this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country. Methods Modified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant. Results The number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572). Conclusion In terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts Disclosures All authors: No reported disclosures.

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Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia

SAGE Open Medicine ◽

10.1177/20503121211001154 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110011

Author(s):

Mequanint Agazhe ◽

Daniel Eshetu ◽

Admasu Arsicha ◽

Assefa Hamato ◽

Assefa Petros ◽

...

Keyword(s):

Ischemic Stroke ◽

Hemorrhagic Stroke ◽

Lifestyle Modification ◽

Public Health Problem ◽

Cross Sectional Study ◽

Southern Ethiopia ◽

P Value ◽

Stroke Patients ◽

Early Screening ◽

Cross Sectional

Introduction: In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital. Methods: An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients’ medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant. Result: From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003). Conclusion: The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.

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COMPARISON OF OUTCOMES AND COGNITIVE FUNCTION IN ACUTE STROKE PATIENTS TREATED AT THE STROKE CORNER OF H. ADAM MALIK GENERAL HOSPITAL MEDAN WITH THOSE TREATED IN WARD OF KESDAM BUKIT BARISAN HOSPITAL MEDAN

International journal of Research science and Management - September-2020 ◽

10.29121/ijrsm.v7.i8.2020.13 ◽

2020 ◽

Vol 7 (8) ◽

pp. 87-93

Keyword(s):

Cognitive Function ◽

Acute Stroke ◽

General Hospital ◽

Patient Outcomes ◽

Primary Data ◽

Bivariate Analysis ◽

P Value ◽

Stroke Patients ◽

Chi Square ◽

Chi Square Test

Background: Stroke is a serious neurological problem that is mostly found in the world, and cognitive impairment is often found in the first few weeks after a stroke, where disturbances in the perception and executive functions are mostly found. Aim: To find out the comparison of outcomes and cognitive function in acute stroke patients treated at the Stroke Corner of H. Adam Malik General Hospital Medan with those treated in the Ward of Kesdam Bukit Barisan Hospital Medan. Methods: This research is descriptive analytic with cross sectional data collection method with primary data source obtained from 44 patients who suffered an acute stroke and was treated at the Stroke Corner of H.Adam Malik General Hospital in Medan and Ward at Kesdam Bukit Barisan Hospital. Then MMSE and CDT were examined to assess cognitive function and NIHSS at initial and day 14 to assess patient outcomes. To assess the comparison of cognitive functions and patient outcomes, a bivariate analysis was performed. Normality test with the Komogrov-Smirnov test, then the Chi Square test was performed and was declared significant if p values <0.05 were obtained. Results: After Chi Square test, it was seen that there were significant differences in cognitive function as measured by MMSE and CDT scores between patients treated at the two hospitals with p value = 0.012 (p <0.05) and p value = 0.004 (p < 0.05), respectively. Then, with the chi square test found significant differences in patient outcomes as measured by the initial NIHSS score and day 14 with p value = 0.018 (p <0.05) and p value = 0.011 (p <0.05), respectively. Conclusions: Significant differences in cognitive function and outcome in acute stroke patients were found between treatment at Stroke Corner H. Adam Malik General Hospital Medan and Ward at Kesdam Bukit Barisan Hospital Medan.

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