Risk Factors and Functional Impact of Medical Complications in Stroke

Kim, Boram; Lee, Jongmin; Sohn, Min Kyun; Kim, Deog Young; Lee, Sam-Gyu; Shin, Yong‐Il; Oh, Gyung-Jae; Lee, Yang-Soo; Joo, Min Cheol; Han, Eun Young; Kim, Yun-Hee

doi:10.5535/arm.2017.41.5.753

Cited by 48 publications

(33 citation statements)

References 33 publications

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“…One multicenter study reported that internal medical complications occurred in 85% of patients with acute stroke. another study comparing ischaemic and hemorrhagic stroke found that the common complications related to post-hemorrhagic stroke, occured during the rehabilitation period were pneumonia (6.72%), urinary tract infection (4.96%), bowel dysfunction (10.26%), and pressure sore (0.69%) (20,21). Multiple logistic regression model showed that stroke onset >3 hours and gi tract bleeding were significant predictors of mortality in patients with hemorrhagic stroke.…”

Section: Discussionmentioning

confidence: 99%

Complications as poor prognostic factors in patients with hemorrhagic stroke: A hospital-based stroke registry

Pinzon¹,

Wijaya²

2020

Ro J Neurol.

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Introduction. Stroke patients commonly experience various medical complications during their rehabilitation stay. Understanding complications in hemorrhagic stroke patients can determine the patients prognosis. Aim. This study aimed to explore complications as prognostic factors among patients with hemorrhagic stroke. Methods. This was an observational analytic study with retrospective design. We analyzed the medical records of 480 patients admitted with hemorrhagic stroke between 2017 and 2018 at Bethesda Hospital, Indonesia. Disability, mortality, and length of stay (LoS) were assessed as clinical outcomes for this study. Multivariate logistic regression was used to analyze the data results. The data were obtained from 480 patients with hemorrhagic stroke that majority of males (58.5%), with < 60 years old (52.3%), stroke onset > 3 hours (87.5%), and had stroke for the first time (82.9%). The most common complications was GI tract bleeding (19.8%), whereas the least was decubitus ulcer (1.5%). There were 25.8% patients died during hospitalization period. Among 356 survivors, there were no significant prognosis factors of disability in subjects. Logistic regression found stroke onset > 3 hours (OR: 0.34; 95%CI: 0.19-0.59; p < 0.001) and GI tract bleeding (OR: 30.8; 95%CI: 16.93-55.88; p < 0.001) to be an independent predictors of mortality in hemorrhagic stroke, whereas GI tract bleeding (OR: 0.54; 95%CI: 0.31-0.95; p = 0.03) and UTI (OR: 4.73; 95%CI: 1.11-20.1; p = 0.04) were also an independent predictors of prolonged length of stay in hemorrhagic stroke. conclusion. This study identify complications as prognostic factors in hemorrhagic stoke patients. Stroke onset > 3 hours, GI tract bleeding, and UTI were independent predictors of poor prognosis in hemorrhagic stroke. There were no prognosis factor that affects disability in subjects.

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Section: Discussionmentioning

confidence: 99%

Complications as poor prognostic factors in patients with hemorrhagic stroke: A hospital-based stroke registry

Pinzon¹,

Wijaya²

2020

Ro J Neurol.

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“…S troke is one of the leading causes of disability (1). In stroke patients, balance can be affected by various factors, such as muscular weakness, abnormal muscle tone, deficits in visual and sensory function or disturbances in vestibular mechanisms (2).…”

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confidence: 99%

Effectiveness of Wii-based rehabilitation in stroke: A randomized controlled study

Karasu

Batur²,

Karataş³

2018

J Rehabil Med

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“…Dependent on how it is measured, 14%–31% of people who sustain a stroke globally are classified as having a severe stroke,13–18 a cohort of the stroke population that experiences worse outcomes compared with survivors of less severe stroke 19–30. In the initial hospitalisation phase poststroke, they are more likely to develop acute medical complications, which are negatively associated with functional recovery 19. Three month mortality can be as high as 40%, compared with just under 5% for those patients with mild stroke 20–22.…”

Section: Introductionmentioning

confidence: 99%

The effect of rehabilitation interventions on physical function and immobility-related complications in severe stroke: a systematic review

et al. 2020

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ObjectiveTo evaluate the effectiveness of rehabilitation interventions on physical function and immobility-related complications in severe stroke.DesignSystematic review of electronic databases (Medline, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Physiotherapy Evidence Database, Database of Research in Stroke, Cochrane Central Register of Controlled Trials) searched between January 1987 and November 2018.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guided the review. Randomised controlled trials comparing the effect of one type of rehabilitation intervention to another intervention, usual care or no intervention on physical function and immobility-related complications for patients with severe stroke were included. Studies that recruited participants with all levels of stroke severity were included only if subgroup analysis based on stroke severity was performed. Two reviewers screened search results, selected studies using predefined selection criteria, extracted data and assessed risk of bias for selected studies using piloted proformas. Marked heterogeneity prevented meta-analysis and a descriptive review was performed. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess evidence strength.Results28 studies (n=2677, mean age 72.7 years, 49.3% males) were included in the review. 24 studies were rated low or very low quality due to high risk of bias and small sample sizes. There was high-quality evidence that very early mobilisation (ie, mobilisation with 24 hours poststroke) and occupational therapy in care homes were no more effective than usual care. There was moderate quality evidence supporting short-term benefits of wrist and finger neuromuscular electrical stimulation in improving wrist extensor and grip strength, additional upper limb training on improving upper limb function and additional lower limb training on improving upper limb function, independence in activities of daily living, gait speed and gait independence.ConclusionsThere is a paucity of high-quality evidence to support the use of rehabilitation interventions to improve physical function and reduce immobility-related complications after severe stroke. Future research investigating more commonly used rehabilitation interventions, particularly to reduce poststroke complications, is required.PROSPERO registration numberCRD42017077737

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Risk Factors and Functional Impact of Medical Complications in Stroke

Cited by 48 publications

References 33 publications

Complications as poor prognostic factors in patients with hemorrhagic stroke: A hospital-based stroke registry

Complications as poor prognostic factors in patients with hemorrhagic stroke: A hospital-based stroke registry

Effectiveness of Wii-based rehabilitation in stroke: A randomized controlled study

The effect of rehabilitation interventions on physical function and immobility-related complications in severe stroke: a systematic review

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