Doshi V S, Say J H, Young S H-Y, Doraisamy P
Division of Geriatric Medicine, Changi General Hospital (CGH), 2 Simei Street 3, Singapore 529889.
Singapore Med J. 2003 Dec;44(12):643-52.
The aim of this study was to look at the type and frequencies of complications after an acute stroke in an inpatient rehabilitation setting. We also looked at the type of complications which required the transfer of patient care back to the primary referring physician.
A retrospective review of case notes of patients transferred to the rehabilitation team was conducted. The study period was a six-month period from the beginning of January 2001 to the end of June 2001. A list of complications was made. Each pre-determined complication was then defined. The frequency of each complication was then calculated.
A total of 140 case notes were reviewed. The overall complication rate was 54.3%. The more common complications, in order, from highest to lowest frequencies, were: constipation (complicating 22.9% of strokes); acute retention of urine (ARU, 20.9%); urinary tract infections (UTI, 14.3%); depression (9.3%); and limb pain (8.6%). Females were more likely to have UTI (p=0.038), ARU (p=0.002) and depression (p=0.018). Patients 65 years and above were more likely to suffer multiple complications although the results did not reach statistical significance (p=0.055). The care for eight patients (5.7% of patients with complications) had to be transferred back to the primary referring team or physician.
Complications post stroke are common. Some patients required transfer of care back to the primary referring physician. A pro-active approach is ideal in all post stroke patients, in order to identify and treat any complications early, thereby, improving outcome and reducing costs.
本研究旨在观察住院康复环境下急性卒中后并发症的类型及发生率。我们还观察了需要将患者护理转回初级转诊医生处的并发症类型。
对转至康复团队的患者病历进行回顾性研究。研究期间为2001年1月1日至2001年6月30日这六个月。列出并发症清单。然后对每种预先确定的并发症进行定义。接着计算每种并发症的发生率。
共回顾了140份病历。总体并发症发生率为54.3%。按发生率从高到低排序，较常见的并发症依次为：便秘（使22.9%的卒中患者出现并发症）；急性尿潴留（ARU，20.9%）；尿路感染（UTI，14.3%）；抑郁（9.3%）；以及肢体疼痛（8.6%）。女性更易发生UTI（p = 0.038）、ARU（p = 0.002）和抑郁（p = 0.018）。65岁及以上患者更易出现多种并发症，尽管结果未达到统计学显著性（p = 0.055）。八名患者（占并发症患者的5.7%）的护理不得不转回初级转诊团队或医生处。
卒中后并发症很常见。一些患者需要将护理转回初级转诊医生处。对所有卒中后患者采取积极主动的方法是理想的，以便早期识别和治疗任何并发症，从而改善预后并降低成本。
