Risk factors for medical complications of acute hemorrhagic stroke

Sidhartha, Jangala Mohan; Purma, Aravinda Reddy; Reddy, Lomati Venkata Pavan Kumar; Sagar, Nagaswaram Krupa; Teja, M. Prabhu; Subbaiah, M. Venkata; Purushothaman, M.

doi:10.1016/j.joad.2015.07.002

Cited by 13 publications

(13 citation statements)

References 13 publications

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“…The main risk factor for stroke among our patients was hypertension. This is consistent with results of Sidhartha et al study in India (2015) ( 18 ) which concluded that hypertension was a major risk factor for medical complications of hemorrhagic stroke. There was a significant association between Intracerebral hemorrhage and systemic hypertension (p<0.001).…”

Section: Discussionsupporting

confidence: 92%

QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

Amin

Al-Bajalan²,

Mubarak³

2017

Med Arch

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Background:A variety of ECG changes occur as an aftermath of stroke. Prolongation of the QTc interval is a well-documented change. We analyzed QTc interval prolongation among patients with acute hemorrhagic strokes.Methods:This observational study was conducted at the Emergency Department of Sulaymaniyah General Teaching Hospital and Shar Hospital from September 1st, 2014 to August 31st, 2015. Fifty patients who developed acute spontaneous hypertensive intracerebral hemorrhage (ICH) and 50 patients who developed acute non-traumatic subarachnoid hemorrhage (SAH) were included in the study. All patients underwent resting 12-lead ECG within half an hour of admission. The QTc interval was calculated and analyzed in those 100 patients.Results:Females (62%) outnumbered males (38%) with a female to male ratio of 1.6:1. Forty percent of the patients were between 60-69 years of age. Hypertension was seen in 82% of patients while left ventricular hypertrophy was documented in 40% of patients. The QTc was prolonged in 38 patients (17 patients in the ICH group and 21 patients in the SAH group). In both groups, males demonstrated QTc prolongation more than females. However, there were no statistically significant gender difference between both groups and within the same group. There was a statistically significant association between SAH and QTc prolongation (p-value<0.001); the ICH group did not demonstrate any significant relationship with QTc prolongation.Conclusion:Prolongation in the QTc interval was “statistically” associated with acute SAH only. No gender difference was noted; whether this observation is clinically significant or not, it needs further analytic studies.

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Section: Discussionsupporting

confidence: 92%

QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

Amin

Al-Bajalan²,

Mubarak³

2017

Med Arch

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“…In this study setup complications were prevalent in majority of the stroke patients (80.2%). This was comparable with observational study conducted at a tertiary care teaching hospital in Kadapa, 75% [47], the RANTTAS trial, 95% [23], study at university hospital of Trondheim in Norway, 82.4% [49], study by Civelek et al conducted in Turkey, 88.9% [27] and prospective, multicenter study in the west of Scotland, 85% [50] of stroke patients had experienced at least one complication. But the rate of the complication was higher compared to a study conducted in ten Asian countries which revealed that 423 (41.9%) developed complications within the first 2 weeks of stroke [51] as well as study in Bromley hospitals NHS Trust, UK where medical complications were documented in 60% of stroke patients [52].…”

Section: Discussionsupporting

confidence: 75%

“…Complications after stroke are common, present barriers to optimal recovery or related to poor outcomes and are potentially preventable or treatable [47]. During the rehabilitation process, patients are vulnerable to various complications as a result of both the stroke and the disability caused by it [27].…”

Section: Discussionmentioning

confidence: 99%

Management protocols and encountered complications among stroke patients admitted to stroke unit of Jimma university medical center, Southwest Ethiopia: Prospective observational study

Fekadu

Chelkeba

Melaku

et al. 2019

Annals of Medicine and Surgery

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ObjectivesThe number of stroke patients receiving recombinant tissue plasminogen activator (r-tPA) in developing world is extremely low. Pre-hospital delay, financial constraints and lack of infrastructure are the main barriers. Additionally, various medical, neurological and psychological complications are allied to stroke patients after the acute attack. Hence, the study was aimed to identify management protocols and encountered complications among stroke patients admitted to stroke unit of Jimma university medical center (JUMC).Patients and methodsProspective observational study was conducted at stroke unit of JUMC from March 10 to July 10, 2017. All eligible consecutive stroke patients of ≥18 years were included. Data was entered to Epi data version 3.1 and analyzed using SPSS version 20.ResultsA total of 116 eligible stroke patients were followed with mean age of 55.14 ± 14.04 years and males comprised of 62.9%. Using world health organization (WHO) criteria, 60 (51.7%) patients had ischemic while 56 (48.3%) had hemorrhagic stroke. During admission, 93 (80.2%) patients had developed at least one complication. The most complication was brain edema (increased intracranial pressure) detected in about one third of the patients (30.2%) followed by urinary incontinence (28.4%) and aspiration pneumonia (19.8%). Almost half of the patients (52.5%) had at least one past medication history. During hospitalization, 111(95.7%) of patients had received at least one medication and the median start time of the medications after hospital arrival was 15 h. The most common medication given for the patients during hospitalization were antiplatelets and statins for 63 (54.3%) patients. During discharge, about 78 (67.2%) patients had received medications and antihypertensives were the prominent medications prescribed for half of the discharged patients.ConclusionBoth neurologic and medical complications were common in majority of stroke patients. But the management protocol for stroke patients was sub-optimal and lagging behind the recommended guidelines due to lack of skilled personnel, appropriate treatment and diagnostic agents. The clinical team involved in the care of stroke patients should make preparations to take preventive measures that will save a lot of lives.

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“…Thus the complication and mortality rates of our patients were somewhat lower than those in previous studies of nursing interventions for stroke patients. 17,[46][47][48] However, previous research has shown that the frequency of such MICs varied owing to differences in study designs and inception cohorts. 2 Moreover, different nursing interventions may result in different outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…10 Research indicates that up to 51% of deaths in the first month after an ischemic stroke were due to complications of immobility and over 62% of these complications occurred in the first seven days of the stroke. 8,11 When patients are bedridden and immobile, the most common complications are pressure injuries (PIs), 1,2,8,12,13 pneumonia, 2,8,[13][14][15][16][17][18] deep vein thrombosis (DVT), 2,8,13,[16][17][18][19][20][21] urinary tract infections (UTIs), 1,13,17,18,22 and constipation. 13,16 These complications present barriers to optimal recovery and positive post-stroke outcomes and, when non-fatal, increase the length of hospital stays as well as the cost of hospital care.…”

Section: Introductionmentioning

confidence: 99%

The effects of a standardized nursing intervention model on immobile patients with stroke: a multicenter study in China

Liu

Zhu

Cao

et al. 2019

European Journal of Cardiovascular Nursing

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Background: Immobility complications, including pressure injuries (PIs), deep vein thrombosis (DVT), pneumonia, and urinary tract infections (UTIs), affect the clinical outcomes of stroke patients. A standardized nursing intervention model (SNIM) was constructed and implemented to improve the quality of care and clinical outcomes among immobile patients with stroke. Aims: To assess the benefit of SNIM for immobility complication rates, including PIs, DVT, pneumonia, and UTIs, and mortalities in immobile patients with stroke. Methods: A before and after study design was used. Patients were divided into a pre- and post-SNIM training original cohort and matched for socioeconomic, demographic, and disease characteristics using propensity score. We fitted logistic regression models to examine the effect of SNIM, and whether the benefit differed between tertiary and non-tertiary hospitals. Results: In the original cohort, the rate of pneumonia, UTIs, and mortality was lower after SNIM training. Furthermore, in the matched cohort, the difference in PI rates was significant. Logistic regression analysis revealed that the probability of PIs, pneumonia, UTIs, and mortality were significantly reduced after SNIM training in the original cohort and this estimated value changed little in the matched cohort. Our results show that the decreased rates of pneumonia, UTIs, and mortality were mainly among non-tertiary hospitals. Conclusions: A structured and systematic SNIM benefited immobile stroke patients’ clinical outcomes, but mainly in non-tertiary hospitals in China. Standardized nursing training is needed in non-tertiary hospitals.

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Risk factors for medical complications of acute hemorrhagic stroke

Cited by 13 publications

References 13 publications

QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

Management protocols and encountered complications among stroke patients admitted to stroke unit of Jimma university medical center, Southwest Ethiopia: Prospective observational study

The effects of a standardized nursing intervention model on immobile patients with stroke: a multicenter study in China

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