THE EFFECT OF NATURE SOUNDS MUSIC THERAPY ON THE GLASGOW COMA SCALE ON STROKE PATIENTS

Latar Belakang: Definisi stroke adalah disfungsi neurologis akut yang disebabkan oleh gangguan aliran darah yang timbul secara tiba-tiba, sehingga suplai darah ke otak terganggu. Di Indonesia 1 dari 7 orang meninggal karena stroke. Insiden stroke adalah 12,1 per 1.000 orang Indonesia. Terapi musik alami adalah salah satu jenis terapi non-farmakologis yang dapat meningkatkan nilai GCS. Tujuan penelitian ini untuk menganalisa efek terapi musik suara alam pada skala koma glascow pada pasien stroke. Metode: Sebuah studi pre eksperimen kuantitatif tanpa kelompok kontrol. Sampel penelitian adalah 35 pasien stroke non hemoragik. Sampel akan mendapatkan terapi musik suara alam selama 3 hari dengan durasi 20 menit dengan volume 50% atau 60dB. Data akan dianalisis menggunakan uji wilcoxon. Hasil: Hasil tes wilcoxon adalah p = 0,000. Artinya, terapi musik suara alam memberi efek pada glascow coma scale pasien stroke. Kesimpulan: Terapi musik suara alam dapat meningkatkan GCS pada pasien stroke.

Download Full-text

Abstract TP235: Deterioration and Improvement in the Field: Comparative Detection by Los Angeles Motor Scale and Glasgow Coma Scale in Acute, EMS-transported Stroke Patients

Stroke ◽

10.1161/str.48.suppl_1.tp235 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Anita Tipirneni ◽

Kristina Shkirkova ◽

Nerses Sanossian ◽

Sidney Starkman ◽

Scott Hamilton ◽

...

Keyword(s):

Cerebral Ischemia ◽

Los Angeles ◽

Glasgow Coma Scale ◽

Intracranial Hemorrhage ◽

Stroke Patients ◽

Coma Scale ◽

Acute Cerebral Ischemia ◽

Stroke Evolution ◽

Global Impression Of Change ◽

Los Angeles Motor Scale

Background: Stroke evolution after hospital arrival is well characterized for acute cerebral ischemia and intracranial hemorrhage. But with the advent of patient routing to designated stroke centers, and of prehospital stroke therapeutic trials, it is important to characterize stroke evolution in the earliest, prehospital moments of onset. Initial studies have prehospital evolution using serial Glasgow Coma Scale (GCS) assessment; however, GCS assesses level of consciousness rather than focal deficits. Methods: In the NIH FAST-MAG trial database, we analyzed patient deficit evolution from time of first paramedic assessment to early post-arrival assessment in the ED, using serial scores on the GCS, serial scores on the Los Angeles Motor Scale (LAMS) (a prehospital stroke deficit measure), and the Paramedic Global Impression of Change (PGIC) score, a 5 point Likert paramedic-clinician score. Results: Among 1632 acute, EMS-transported neurovascular disease patients, 1,245 (76.3%) had a final diagnosis of acute cerebral ischemia and 387 (23.7%) of acute intracranial hemorrhage. Time of paramedic initial assessment was median 23 mins (IQR 14-41) after onset and time of early ED assessment 58 mins (IQR 46-78). Considering score changes by 2 or more as salient, overall the LAMS and GCS indicated approximately equal frequencies of prehospital deterioration (LAMS 11.1%, GCS 12.0%), but the LAMS indicated higher frequencies of prehospital improvement (LAMS 24.5% vs GCS 5.7%, p<0.001), due to the ceiling constraint of the GCS. The LAMS correlated more strongly than the GCS with the paramedic global impression of change among all patients, r=0.31 vs 0.19, and especially in acute cerebral ischemia patients, r=0.27 vs 0.08). The prehospital course differed by stroke subtype on the LAMS: acute cerebral ischemia: improved 30.7%, worsened 7.1%, stable 62.25%; intracranial hemorrhage: improved 4.5%, worsened 24.2%, stable 71.3%. Conclusions: Focal deficit scales are superior to the GCS in characterizing prehospital stroke evolution. Change in neurologic status occurs in more than one-third of acute stroke patients during transport and the early ED, with improvement more common in acute cerebral ischemia and deterioration more common in ICH.

Download Full-text

The relationship between pneumonia and Glasgow coma scale assessment on acute stroke patients

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/125/1/012204 ◽

2018 ◽

Vol 125 ◽

pp. 012204

Author(s):

K Ritarwan ◽

C A Batubara ◽

R Dhanu

Keyword(s):

Glasgow Coma Scale ◽

Acute Stroke ◽

Stroke Patients ◽

Coma Scale ◽

Scale Assessment ◽

The Relationship

Download Full-text

Pengaruh Familiar Auditory Sensory Training Pada Tingkat Kesadaran Pasien Stroke Di RSD dr. Soebandi Jember

JURNAL PENDIDIKAN KEPERAWATAN INDONESIA ◽

10.17509/jpki.v6i2.26917 ◽

2020 ◽

Vol 6 (2) ◽

Author(s):

Cirilia Aripratiwi ◽

Jon Hafan Sutawardana ◽

Mulia Hakam

Keyword(s):

Glasgow Coma Scale ◽

Pharmacological Therapy ◽

Wilcoxon Test ◽

Neurological Deficits ◽

Control Group ◽

P Value ◽

Stroke Patients ◽

Coma Scale ◽

Patient Awareness ◽

Sensory Training

ABSTRAKStroke dapat menyebabkan penurunan kesadaran. Pada kasus stroke dengan penurunan kesadaran dapat mengakibatkan pasien mengalami kematian, defisit neurologi, semakin lamanya waktu perawatan, dan akan meningkatkan biyaya perawatan. Kasus stroke dengan penurunan kesadaran banyak dijumpai di RSD dr. Soebandi Jember. Namun upaya perawat dalam meningkatkan kesadaran pasien berfokus pada terapi farmakologi sehingga memerlukan terapi non farmakologi seperti terapi Familiar Auditory Sensory Training (FAST) untuk membantu proses pemulihan kesadaran. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh FAST pada tingkat kesadaran pasien stroke. Penelitian didesain dengan quasi experimental menggunakan rancangan Non equivalent control group melibatkan 29 pasien stroke yang mengalami penurunan kesadaran. 29 pasien dibagi menjadi 15 kelompok intervensi yang diberi terapi FAST selama tiga hari. FAST diberikan 3 kali sehari. 14 pasien berikutnya dalam kelompok kontrol hanya dilakukan pemeriksaan GCS. Tingkat kesadaran pasien diukur menggunakan instrumen Glasgow Coma Scale (GCS) yang terdiri dari 3 komponen yakni respon mata, verbal, dan motorik. Data dianalisis dalam SPSS menggunakan uji Mann-Whitney dan uji Wilcoxon. Hasil analisis uji baik pada kelompok intervensi maupun kontrol diperoleh nilai p 0,010 (nilai p α). Hasil uji yang signifikan membuktikan bahwa ada pengaruh FAST dalam meningkatkan kesadaran pasien stroke. FAST dapat dijadikan terapi nonfarmakologi untuk membantu proses pemulihan kesadaran pada pasien stroke.ABSTRACTStroke can cause a decrease in consciousness. In the case of stroke with decreased consciousness can result in the patient experiencing death, neurological deficits, the longer treatment time, and will increase the cost of treatment. Cases of stroke with decreased consciousness are often found in RSD dr. Soebandi Jember. However, nurses' efforts in increasing patient awareness focus on pharmacological therapy so that it requires non-pharmacological therapy such as Familiar Auditory Sensory Training (FAST) therapy to help the process of recovering consciousness. The purpose of this study was to determine the effect of FAST on the level of awareness of stroke patients. This study involved 29 stroke patients who experienced a decrease in consciousness. 29 patients were divided into 15 intervention groups who were given FAST therapy for three days. FAST is given 3 times a day. The next 14 patients in the control group only performed GCS examination. The level of patient awareness was measured using the Glasgow Coma Scale (GCS) instrument consisting of 3 components namely eye, verbal, and motor response. Data were analyzed in SPSS using the Mann-Whitney test and Wilcoxon test. The results of the test analysis in the intervention and control groups obtained p-value 0.010 (p-value α). Significant test results prove that there is an influence of FAST in increasing stroke patient awareness. This study shows that nurses should be able to increase the application of nonpharmacological therapies such as FAST to help the process of recovering consciousness in stroke patients.

Download Full-text

Lower GCS is Related to Poor Outcome among Acute Stroke Patients with COVID-19 in A Tertiary Referral Hospital in Indonesia

The Indonesian Biomedical Journal ◽

10.18585/inabj.v13i4.1700 ◽

2021 ◽

Vol 13 (4) ◽

pp. 409-17

Author(s):

Mieke Actress Hanna Nelly Kembuan ◽

Arthur Hendrik Philips Mawuntu ◽

Yohanna Yohanna ◽

Feliana Feliana ◽

Melke Joanne Tumboimbela

Keyword(s):

Glasgow Coma Scale ◽

Acute Stroke ◽

Referral Hospital ◽

First Year ◽

Stroke Patients ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Coma Scale ◽

Poor Outcome ◽

Logistic Regression Method

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has forced the health workforce to take mitigative measures such as physical distancing, screening, personal protective equipment donning, and confinement on patient care. We aimed to study the outcome of acute stroke patients with suspected, probable, or confirmed COVID-19 in a tertiary referral hospital in Indonesia during the first year of COVID-19 pandemic.METHODS: This was a retrospective study examining all medical records of adult patients suffering from acute stroke with suspected or confirmed COVID-19 who were admitted to R.D. Kandou Hospital, Manado, Indonesia, between March 2020 to March 2021. Clinical and laboratory parameters were compared between subjects with poor and good outcomes based on Glasgow Outcome Scale (GOS), divided into poor outcome (GOS 1-3) and good outcome (GOS 4-5).RESULTS: Fourty-six eligible subjects were enrolled in the study. Based on the GOS, 36 subjects (78.3%) were admitted to the hospital with poor prognosis. On admission, the median Glasgow Coma Scale (GCS) was 11, breathlessness was found in 54.3% of subjects, fever was found in only 15 subjects (32.6%), and the lowest oxygen saturation on admission 95%. We found that GCS significantly related to outcome after controlled for other factors using the logistic regression method (p=0.03; 95% CI=1.08-4.78).CONCLUSION: Lower GCS can be used to predict poor outcome in acute stroke patients with COVID-19.KEYWORDS: COVID-19, acute stroke, Glasgow Coma Scale, outcome, Indonesia

Download Full-text

Correlation of Glasgow Coma Scale Score at Hospital Admission with Stroke Hemorrhagic Patient Mortality at Hasan Sadikin Hospital

Journal Of Medicine & Health ◽

10.28932/jmh.v2i4.1139 ◽

2019 ◽

Vol 2 (4) ◽

Author(s):

Ary Setio Hartanto ◽

Andi Basuki ◽

Cep Juli

Keyword(s):

Glasgow Coma Scale ◽

Hospital Admission ◽

Hemorrhagic Stroke ◽

P Value ◽

Stroke Patients ◽

Coma Scale ◽

Risk Of Death ◽

Increased Risk ◽

Level Of Consciousness ◽

Gcs Score

Stroke is the most common cause of death in Indonesia. Stroke is divided into ischemic and hemorrhagic stroke. Hemorrhagic stroke has a higher risk of death than ischemic stroke. Hemorrhagic stroke can disrupt patient’s consciousness. The Glasgow Coma Scale (GCS) is a scale that is widely used to assess level of consciousness. Accurate predictors can help doctors determine prognosis and treatment for stroke patient. This study was conducted to determine the correlation of GCS scores at the time of hospital admission and mortality of hemorrhagic stroke patients at Hasan Sadikin Hospital. This study is a retrospective cohort analytic study involving 134 subjects. Data were analyzed using Kolmogorov-Smirnov’s and Fisher's analysis test with significance of p <0.05. From the results of the study, the p value was 0.00, subjects with GCS score somnolence (12-14) had six times higher risk in mortality (P = 0.02, RR = 6.38) and subjects with GCS score sopor and coma (3 - 11) had twenty four times higher risk in mortality (P = 0.00, RR = 23.85). We concluded that decreased score of SKG at the time of hospital admission was associated with increased risk of death in hemorrhagic stroke patients at Hasan Sadikin Hospital. Keywords: Glasgow Coma Scale, hemorrhagic stroke, mortality

Download Full-text

RESEARCH IN SERUM COPEPTIN CONCENTRATION IN THE ACUTE STROKE PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.22 ◽

2017 ◽

pp. 156-163

Author(s):

Thanh Cong Nguyen ◽

Thi Bich Thuan Le ◽

Chuyen Le ◽

Thi Minh Phuong Phan

Keyword(s):

Ischemic Stroke ◽

Glasgow Coma Scale ◽

Intracerebral Hemorrhage ◽

Acute Stroke ◽

Acute Ischemic Stroke ◽

Scale Score ◽

Glasgow Coma Scale Score ◽

Stroke Patients ◽

Nihss Score ◽

Coma Scale

Objectives: To determine serum Copeptin concentration and correlation between serum Copeptin concentration with some major predictors of acute stroke patients (ischemic stroke and intracerebral hemorrhage). Subjects and Methods: Cross-sectional descriptive study with 72 patients (40 acute ischemic stroke patients and 32 intracerebral hemorrhage patients at Hue University Hospital. Data processing method is according to usual medical statistics and SPSS 20.0. Results: 1. The serum Copeptin concentration in the patients with acute stroke: - The serum Copeptin concentration in the patients with acute ischemic stroke was 11.28 ± 5.2 pmol/L (admission) and 8.81 ± 4.94 pmol/L (after 7 days). - The serum Copeptin concentration in the patients with acute intracerebral hemorrhage was 9.17 ± 7.97 pmol/L (admission) and 7.14 ± 6.62 pmol/L (after 7 days). - The serum Copeptin concentration in the patients with acute stroke at admission and after 7 days there was not statistically significant difference between female and male (p > 0.05). 2. The correlation between serum Copeptin concentration and severity of acute stroke patients: - The serum Copeptin concentration correlated positively with size of injury (ischemic stroke: r = 0.743; p< 0.001 and intracerebral hemorrhage: r = 0.502; p= 0.003). - The serum Copeptin concentration in the acute stroke patients correlated positively with NIHSS score at admission (ischemic stroke: r = 0.657, p < 0.001 and intracerebral hemorrhage: r = 0.408, p = 0.021). - The serum Copeptin concentration in the acute stroke patients correlated positively with NIHSS score after 7 days (ischemic stroke: r = 0.486, p < 0.001 and intracerebral hemorrhage: r = 0.359, p = 0.044). - The serum Copeptin concentration in the acute stroke patients correlated negatively with Glasgow Coma Scale score at admission (ischemic stroke: r = - 0.564, p < 0.001 and intracerebral hemorrhage: r = - 0.466, p = 0.007).The serum Copeptin concentration in the acute stroke patients correlated negatively with Glasgow Coma Scale score after 7 days (ischemic stroke: r = - 0.499, p < 0.001 and intracerebral hemorrhage: r = - 0.38, p = 0.032). Conclusions: There was correlation between serum Copeptin concentration with severity of acute stroke patients. Key words: Copeptin, acute stroke, ischemic stroke, intracerebral hemorrhage

Download Full-text

Hubungan antara Waktu Tindakan Intubasi dengan Outcome Pasien Stroke di RSUP Prof. Dr. R. D. Kandou Manado: Kajian terhadap Glasgow Coma Scale, Ventilator Associated Pneumonia, Length of Stay, dan Angka Kematian

e-CliniC ◽

10.35790/ecl.6.2.2018.22126 ◽

2018 ◽

Vol 6 (2) ◽

Author(s):

Timothy M. Poluan ◽

Diana C. H. Lalenoh ◽

Barry I. Kambey

Keyword(s):

Mechanical Ventilation ◽

Length Of Stay ◽

Glasgow Coma Scale ◽

Ventilator Associated Pneumonia ◽

Intubation Time ◽

Stroke Patients ◽

Keywords Stroke ◽

Coma Scale ◽

Patient’S Outcome ◽

Gcs Score

Abstract: Stroke patients with decreased consciousness, airway disorders, hypoxia, apnea or therapeutic initiation of hyperventilation must be intubated. The delay in intubation time in stroke patients with a deteriorating general condition is very dangerous because it is related to higher mortality within the first 24 to 48 hours and will affect the length of stay (LOS). One of the indications for intubation in stroke patients is the decrease in consciousness, namely the Glasgow Coma Scale (GCS) score <9. Albeit, intubation and mechanical ventilation can cause a person 6 to 21 times more likely to develop pneumonia, commonly referred to as ventilator associated pneumonia (VAP). This study was conducted at Prof. Dr. R. D. Kandou Hospital Manado and was aimed to obtain the correlation between time of intubation and stroke patient’s outcome based on GCS, VAP, LOS, and mortality. The results showed that there was no relationship between time of intubation <48 hours or ≥48 hours after stroke and improvement of GCS (0%); between time of intubation <48 hours or ≥48 hours after stroke and the occurence of VAP (P=0.698); and between time of intubation <48 hours or ≥48 hours after stroke and LOS (r=0.265; P=0.054); as well as between time of intubation <48 hours or ≥48 hours after stroke and mortality in the first two days after intubation (P=0.313).Keywords: stroke, time of intubation, outcome. Abstrak: Pasien stroke dengan penurunan kesadaran, gangguan jalan napas, hipoksia, apnea atau inisiasi terapetik hiperventilasi harus diintubasi. Penundaan waktu tindakan intubasi pada pasien stroke dengan keadaan umum yang memburuk sangat berisiko karena berkaitan dengan mortalitas dalam waktu 24-48 jam pertama dan akan memengaruhi length of stay (LOS). Indikasi dilakukannya intubasi terhadap pasien stroke salah satunya ialah penurunan kesadaran yang dinilai dengan skor Glasgow Coma Scale (GCS) <9. Intubasi dan ventilasi mekanik dapat menyebabkan seseorang 6 sampai 21 kali lipat cenderung terkena pneumonia (ventilator associated pneumonia/VAP). Penelitian ini bertujuan untuk mendapatkan hubungan antara waktu tindakan intubasi dengan outcome pasien stroke di RSUP Prof. Dr. R. D. Kandou Manado dengan menggunakan kajian terhadap GCS, VAP, LOS, dan angka kematian. Hasil penelitian memperlihatkan tidak terdapat hubungan antara waktu tindakan intubasi <48 jam atau ≥48 jam setelah serangan stroke dengan perbaikan GCS (0%); dengan kejadian VAP (P=0,698); dengan LOS (r=0,265; P=0,054); dan dengan angka kematian pada 2 hari pertama setelah diintubasi (P=0,313).Kata kunci: stroke, waktu tindakan intubasi, outcome

Download Full-text