Thapa Lekh Jjung, Shrestha Asis, Pokhrel Baburam, Poudel Raju, Rana P V S
College of Medical Sciences Teaching Hospital, Department of Neurology, Bharatpur, Nepal.
JNMA J Nepal Med Assoc. 2013 Apr-Jun;52(190):332-6.
Stroke is the second most common cause of death and major cause of disability worldwide. About a quarter of stroke patients are dead within a month, about a third by six months, and a half by one year. Although the most substantial advance in stroke has been the routine management of patients in stroke care units, Intensive Care Unit has remained the choice for stroke patients' care in developing countries. This study explores the mortality of stroke patients in ICU setting in tertiary care neurological centre in a developing country.
We collected data of stroke patients admitted in our ICU from August 2009 to August 2010 and analyzed.
Total 44 (10.25%) patients were admitted for acute stroke. Age ranged from 17-93 years. Low Glasgow Coma Scale (GCS), uncontrolled hypertension and aspiration pneumonia were common indications for admission in ICU. Total 23 (52.3%) patients had hemorrhagic stroke and 21 (47.7%) patients had ischemic stroke. Total 13 (29.54%) patients of stroke died within seven days, nine (69.23%) patients of hemorrhagic stroke died within six days, and four patients (30.76%) of ischemic stroke died within seven days and six (13.63%) patients left hospital against medical advice. All of these patients had ischemic stroke.
Stroke mortality in ICU remains high despite of care in tertiary neurological center in resource poor settings. Stroke Care Unit, which would also help dissemination of knowledge of stroke management, is an option for improved outcome in developing countries.
中风是全球第二大常见死因和主要致残原因。约四分之一的中风患者在一个月内死亡,约三分之一在六个月内死亡,一半在一年内死亡。尽管中风治疗方面最显著的进展是在中风护理单元对患者进行常规管理,但在发展中国家,重症监护病房仍然是中风患者护理的选择。本研究探讨了在一个发展中国家的三级神经科中心的重症监护病房环境中中风患者的死亡率。
我们收集了2009年8月至2010年8月入住我们重症监护病房的中风患者的数据并进行了分析。
共有44名(10.25%)患者因急性中风入院。年龄范围为17至93岁。低格拉斯哥昏迷量表(GCS)评分、未控制的高血压和吸入性肺炎是入住重症监护病房的常见原因。共有23名(52.3%)患者为出血性中风,21名(47.7%)患者为缺血性中风。共有13名(29.54%)中风患者在七天内死亡,9名(69.23%)出血性中风患者在六天内死亡,4名(30.76%)缺血性中风患者在七天内死亡,6名(13.63%)患者不听从医嘱离院。所有这些离院患者均为缺血性中风。
尽管在资源匮乏地区的三级神经科中心进行了治疗,但重症监护病房中的中风死亡率仍然很高。中风护理单元有助于传播中风管理知识,是发展中国家改善治疗结果的一个选择。