Impact of Admission Time on Treatment and Outcome of Stroke in Patients Admitted to Tertiary Care Hospital: A Pilot Study from Central India

Nayak, Amit R.; Husain, Aliabbas A.; Lande, Neha H.; Kawle, Anuja P.; Kabra, Dinesh; Taori, Girdhar M.; Daginawala, Hatim F.; Kashyap, Rajpal S.

doi:10.7860/jcdr/2015/12000.6106

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…The observed association of delayed admission with poor treatment outcomes in stroke patients may result poor outcomes of stroke by reducing therapeutic interventions at a time when the brain is primed for. Admission of patients within the window period has been linked with efficacy of treatment and fast recovery [ 39 ]. This finding has the following important implication.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia

Zewudie

Regasa

Hambisa

et al. 2020

Stroke Research and Treatment

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Background. Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). Methods. A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome. Results. Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001 ), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001 ), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001 ), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03 ) were independent predictors of poor treatment outcomes. Conclusion. Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).

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Section: Discussionmentioning

confidence: 99%

Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia

Zewudie

Regasa

Hambisa

et al. 2020

Stroke Research and Treatment

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“…[ 3 ] A crucial predictor of favorable outcomes after stroke is its prompt treatment within a narrow therapeutic window period. [ 4 , 5 ] Thrombolytic therapy comprises the use of recombinant tissue plasminogen activator drugs such as alteplase and tenecteplase. There is a provision for endovascular thrombolysis for ischemic stroke with an extended window period of 6–24 h. [ 6 ] Still there is a delay in seeking medical attention after a stroke, which may be due to lack of recognition of its warning symptoms and carers being unaware of the window period for obtaining treatment.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of stroke and the window period for thrombolytic therapy in ischemic stroke among South Indians: A hospital-based survey with educational intervention

Ali,

Manorenj,

Zafar

2024

JNRP

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Objectives: The objective of this study was to determine the awareness of stroke in regards to the risk factors, warning symptoms, and knowledge of the therapeutic window period among varied strata of non-medical people attending a tertiary care center. Materials and Methods: The interventional study involved the collection of data regarding awareness of stroke using a structured questionnaire with a total score of 16. Pre-intervention assessment was followed by intervention in the form of education regarding awareness of stroke administered one-on-one for personalized and effective comprehension by subjects. Then, subjects were asked to recall the information that was delivered to them and were scored accordingly. Results: Among the 500 subjects included, 51% were female. About 76.8% of participants were young (age <50 years), and 83.4% were literate. Only 25.4% of participants were aware of the brain as the site of stroke. About 32.2% of candidates were aware of a few risk factors for stroke. Among them, the majority of participants were aware of hypertension (24%) as a risk factor. The most known warning symptom was “Numbness” or weakness of arm. The majority of the subjects (97.8%) were unaware of a therapeutic window period for stroke being 4.5 h or below. The mean pre-intervention score was 2.52 ± 1.65 while the mean post-intervention score was 15.10 ± 1.79 (P < 0.0001). Conclusion: The study showed that even among literate participants, only a meager number of subjects were aware of the golden window period of intravenous thrombolysis. Educational intervention by means of an in-person and one-on-one explanation achieved significant levels of understanding of stroke. The study could be used to formulate large-scale educational programs that focus on spreading awareness of symptoms and risk factors while also instilling the importance of timely medical intervention for efficient thrombolytic therapy.

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“…6 Stroke morbidity and mortality can be significantly reduced if patient gets immediate care after the onset. 7,8 Immediate care of stroke partially depends on the knowledge of stroke. 9 Knowledge of stroke's risk factors may prevent 80% of the concurrent stroke.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of Stroke among Hypertensive Patients in Dhulikhel

Nepal

Chand

Poudel

et al. 2022

Kathmandu Univ. Med. J.

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Background More than 50% of patients with stroke have hypertension, a common modifiable risk factor for stroke. Studies reported that 90% of diagnosed hypertensive patients do not seek for treatment in Nepal and the reason for this remains unexplored. There is a possibility that lack of knowledge of stroke and its potential causes may be the reason. Objective To assess the knowledge of stroke in a group of patients with hypertension in suburban Nepal. Method Hypertensive patients visiting a tertiary care hospital in Nepal were approached and were included if they were 18 years or older. We used the Nepali version of ‘Awareness of Stroke, Risk Factors, and Treatment’ questionnaire to assess the knowledge of stroke. Descriptive statistics were used to analyze the results. Result A total of 273 patients were included with the mean age of 56 years. Almost half (48%) of the patients were uneducated. We found that only 24% of the patients identified brain as an organ affected by stroke, only 32% were aware about more than one warning signs of stroke, 64% reported that they were unaware of the treatment options for stroke and only 5% reported control of blood pressure as a part of stroke management. The commonest reported identifiable risk factor for hypertension was high blood pressure (44%). Conclusion There are significant knowledge gaps regarding stroke in hypertensive patients. Although most patients recognized hypertension as a risk factor for stroke, they were unaware of treatment options. Increasing awareness of hypertension as a risk factor for stroke may help to prevent the stroke burden in Nepal.

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Impact of Admission Time on Treatment and Outcome of Stroke in Patients Admitted to Tertiary Care Hospital: A Pilot Study from Central India

Cited by 4 publications

References 17 publications

Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia

Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia

Knowledge of stroke and the window period for thrombolytic therapy in ischemic stroke among South Indians: A hospital-based survey with educational intervention

Knowledge of Stroke among Hypertensive Patients in Dhulikhel

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