The results of the assessment of the condition at the time of admission to the hospital, the functional result at the time of discharge and planning of the outpatient stage in stroke patients according to the register of hospitals in Vinnytsia for 2017-20


Keywords: stroke, Glasgow com scale, NIHSS stroke scale, carotid angioplasty, functional gait test, neurorehabilitation.

Abstract

Annotation. Improving approaches to the diagnosis, treatment and rehabilitation of stroke is a priority, as this disease is not only a medical but also a social problem. The purpose of the work is to assess the dynamics of the indicators at the time of admission to the hospital, the functional result at the time of discharge and planning of the outpatient stage in stroke patients of hospitals in Vinnytsia for the period 2017–2019. The stroke register is formed on the basis of medical documentation of medical institutions, which are the most typical for this region of Ukraine. Statistical processing of the results was performed using the licensed statistical package “Statistica 5.5” using parametric evaluation methods. Significant differences in the indicators of the effectiveness of the organization of medical care for stroke at the pre-hospital and hospital stage between the two medical institutions of Vinnytsia, as well as in the dynamics of observation time. The positive and negative aspects of medical and diagnostic work of these hospitals are analyzed. A number of factors influencing the success of treatment outcome and comprehensive rehabilitation of stroke patients are analyzed. Modern views on the problem of analysis of clinical data using the method of register and medical statistics are presented.

References

1. Belova, A. N. (2004). Shkaly`, testy` i oprosniki v nevrologii i nejrokhirurgii [Scales, tests and questionnaires in neurology and neurosurgery]. M.: Izd-vo Samarskij dom pechati – M.: Publishing house Samara Printing House.

2. Bokeryia, L. A., Pokrovskyi, A. V., Sokurenko, G. Yu., Samorodskaia, I. V., Abuhov, S. A., & Alekian, B. G. (2013). Naczional`ny`e rekomendaczii po vedeniyu paczientov s zabolevaniyami brakhioczefal`ny`kh arterij [National guidelines for the management of patients with brachiocephalic artery disease]. Rossijskij soglasitel`ny`j dokument – Russian consensus document.

3. Bondar, O. B., Pershyna, Yu. V., Ybrahymova, E. L., & Bondar, B. E. (2010). Rol` klinicheskikh shkal v oczenke ostrogo i vosstanovitel`nogo periodov insul`ta [The role of clinical scales in assessing the acute and recovery periods of stroke]. Ukrayins`kij vi`snik psikhonevrologi`yi – Ukrainian Bulletin of Psychoneurology, 18, (4), 10–15.

4. Bykov, A. T., & Maliarenko, T. N. (2013). Fizicheskaya aktivnost` kak vazhnejshij komponent pervichnoj i vtorichnoj profilaktiki insul`ta [Physical activity as an essential component of primary and secondary stroke prevention]. Mediczinskij zhurnal – Medical journal, 2, 4–8.

5. Gusev, E. I., Vylenskyi, B. S., & Skoromets, A. A. (1995). Osnovny`e faktory`, vliyayushhie na iskhody` insul`tov [Key factors affecting stroke outcomes]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova – Journal of Neurology and Psychiatry n.a. S. S. Korsakov, 95 (1), 4–7.

6. Evtushenko, С. К., Yanovskaia, N. V., Sukhonosova, O. Yu., Omelianenko, A. A., & Fomycheva, E. M. (2015). Shkaly` v obshhej i detskoj nevrologii. Nauchno-prakticheskoe i metodicheskoe posobie. S. K. Evtushenko (Red.). [Scales in general and pediatric neurology. Scientific and practical and methodological manual. S. K. Evtushenko (Ed.)]. Izdatel`skij dom: Zaslavskij A.Yu. – Publishing House: Zaslavsky A.Yu.

7. Kosyvtsova, O. V. (2014). Vedenie paczientov v vosstanovitel`nom periode insul`ta [Management of patients in the recovery period of a stroke]. Nevrologiya, nejropsikhiatriya, psikhosomatika – Neurology, neuropsychiatry, psychosomatics, (4), 101–105.

8. Martsevych, S. Yu., Kutyshenko, N. P., Suvorov, A. Yu., Gynzburh, M. L., Deev, A. D., & Boitsov, S. A. (2015). Analiz anamnesticheskikh faktorov i ikh rol` v opredelenii blizhajshego (gospital`nogo) prognoza u bol`ny`kh, perenesshikh mozgovoj insul`t ili tranzitornuyu ishemicheskuyu ataku. Rezul`taty` registra LIS-2 [Analysis of anamnestic factors and their role in determining the closest (hospital) prognosis in patients after a stroke or transient ischemic attack. LIS-2 register results]. Rossijskij kardiologicheskij zhurnal – Russian Journal of Cardiology, 6 (122), 14–19.

9. Merkholts, Ya., Karr, L. Kh., & Flemyh, K. (2014). Rannyaya reabilitacziya posle insul`ta [Early rehabilitation after a stroke]. M.: MEDpress-inform – М.: MEDpress-inform.

10. Bayraktar, Y. S., Sahinoglu, M., Cicekci, F., Inci, K. A. R. A., Karabagli, H., Duman, A., & Celik, J. B. (2019). Comparison of Glasgow Coma Scale and Full Outline of Unresponsiveness (Four) Score: A Prospective Study. Turkish neurosurgery, 29 (2), 1–4. doi: 10.5137/1019-5149.JTN.24175–18.2.

11. Brott, T., Adams Jr, H. P., Olinger, C. P., Marler, J. R., Barsan, W. G., Biller, J., ... & Hertzberg, V. (1989). Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 20 (7), 864–870. doi: 10.1161/01.str.20.7.864.

12. Broughton, B. R. S., Reutens, D. C., & Sobey, C. G. (2009). Apoptotic Mechanisms after Cerebral Ischemia. Stroke, 40, e331–e339. doi: 10.1161/STROKEAHA.108.531632.

13. Cabral, N. L., Nagel, V., Conforto, A. B., Amaral, C. H., Venancio, V. G., Safanelli, J., ... & Zetola, V. D. H. F. (2018). Five-year survival, disability, and recurrence after first-ever stroke in a middle-income country: a population-based study in Joinvile, Brazil. International Journal of Stroke, 13 (7), 725–733. doi: 10.1177/1747493018763906.

14. Etches, V., Frank, J., Di Ruggiero, E., & Manuel, D. (2006). Measuring population health: A review of indicators. Annu. Rev. Public Health, 27, 29–55. doi: 10.1146/annurev.publhealth.27.021405.102141.

15. Fang, M. C., Go, A. S., Chang, Y., Borowsky, L. H., Pomernacki, N. K., Udaltsova, N., & Singer, D. E. (2014). Long-term survival after ischemic stroke in patients with atrial fibrillation. Neurology, 82 (12), 1033–1037. doi: 10.1212/WNL.0000000000000248.

16. Feng, W., & Belagaje, S. R. (2013, November). Recent advances in stroke recovery and rehabilitation. In Seminars in neurology (Vol. 33, No. 05, pp. 498–506). Thieme Medical Publishers. doi: 10.1055/s-0033-1364215.

17. Furie, K. L., Kasner, S. E., Adams, R. J., Albers, G. W., Bush, R. L., Fagan, S. C., ... & Mitchell, P. H. (2011). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 42 (1), 227–276. doi: 10.1161/STR.0b013e3181f7d043.

18. Hobart, J. C., Cano, S. J., Zajicek, J. P., & Thompson, A. J. (2007). Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations. The Lancet Neurology, 6 (12), 1094–1105. doi: 10.1016/S1474-4422(07)70290-9.

19. Karabıyık, L. (2010). Intensive care scoring systems. Turkish Journal of Intensive Care Medicine, 9 (3), 129–143.

20. Khanal, K., Bhandari, S. S., Shrestha, N., Acharya, S. P., & Marhatta, M. N. (2016). Comparison of outcome predictions by the Glasgow coma scale and the Full Outline of UnResponsiveness score in the neurological and neurosurgical patients in the Intensive Care Unit. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 20 (8), 473–476. doi: 10.4103/0972-5229.188199.

21. Kim, D., Lee, S. H., Joon Kim, B., Jung, K. H., Yu, K. H., Lee, B. C., ... & Korean Stroke Registry investigators. (2013). Secondary prevention by stroke subtype: a nationwide follow-up study in 46 108 patients after acute ischaemic stroke. European heart journal, 34 (35), 2760–2767. doi: 10.1093/eurheartj/eht185.

22. Prabhakaran, S., Zarahn, E., Riley, C., Speizer, A., Chong, J. Y., Lazar, R. M., ... & Krakauer, J. W. (2008). Inter-individual variability in the capacity for motor recovery after ischemic stroke. Neurorehabilitation and neural repair, 22 (1), 64–71. doi: 10.1177/1545968307305302.

23. Sarfo, F. S., Akassi, J., Kyem, G., Adamu, S., Awuah, D., Kantanka, O. S., & Ovbiagele, B. (2018). Long-term outcomes of stroke in a Ghanaian outpatient clinic. Journal of Stroke and Cerebrovascular Diseases, 27 (4), 1090–1099. doi: 10.1016/j.jstrokecerebrovasdis.2017.11.017.

24. Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness: a practical scale. The Lancet, 304 (7872), 81–84. doi: 10.1016/s0140-6736(74)91639-0.

25. Thrift, A. G., Thayabaranathan, T., Howard, G., Howard, V. J., Rothwell, P. M., Feigin, V. L., ... & Cadilhac, D. A. (2017). Global stroke statistics. International Journal of Stroke, 12 (1), 13–32. doi: 10.1177/1747493016676285.

26. VanSwearingen, J. M., Perera, S., Brach, J. S., Wert, D., & Studenski, S. A. (2011). Impact of exercise to improve gait efficiency on activity and participation in older adults with mobility limitations: a randomized controlled trial. Physical therapy, 91 (12), 1740–1751. doi: 10.2522/ptj.20100391.

27. Webster, F., Saposnik, G., Kapral, M. K., Fang, J., O'Callaghan, C., & Hachinski, V. (2011). Organized outpatient care: stroke prevention clinic referrals are associated with reduced mortality after transient ischemic attack and ischemic stroke. Stroke, 42 (11), 3176–3182. doi: 10.1161/STROKEAHA.111.621524.
Published
2020-05-18
How to Cite
Fiks, D. (2020). The results of the assessment of the condition at the time of admission to the hospital, the functional result at the time of discharge and planning of the outpatient stage in stroke patients according to the register of hospitals in Vinnytsia for 2017-20. Reports of Vinnytsia National Medical University, 24(1), 175-184. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2020-24(1)-33
Section
SOCIAL MEDICINE, ORGANIZATION OF HEALTH PROTECTION