Devyani Azad, Banandur Pradeep S, Sukumar Gautham Melur, Kulkarni Girish Baburao, Mythirayee S, Rathore Himani
Department of Epidemiology, NIMHANS, Bengaluru, Karnataka, India.
Department of Neurology, NIMHANS, Bengaluru, Karnataka, India.
Indian J Community Med. 2025 Jan-Feb;50(1):25-33. doi: 10.4103/ijcm.ijcm_713_23. Epub 2025 Jan 23.
Stroke is a major public health and clinical challenge that results in significant mortality and disability. Stroke survivors require care and support, particularly during the crucial 3 months post-stroke when 95% of functional neurological recovery occurs. To estimate case-fatality and extent of disability, assess perceived needs, barriers, and unmet needs for care, and ascertain pathways to care post-discharge (at 3 months) among first-ever stroke patients attending a tertiary care neuro-specialty center in India.
A cross-sectional descriptive study was conducted among patients receiving care within [NIMHANS]. Patients with confirmed computed tomography (CT) scans experiencing their first-ever stroke between September 1 and October 31, 2022, were contacted between November 1, 2022, and March 31, 2023. A pre-tested semi-structured questionnaire was used to collect information. Descriptive statistics were performed using STATA version 16.
Stroke fatality among study subjects was 13.8%. Almost half (49.09%) had some form of disability, with 40% having moderate to severe disability. The majority perceived the need for follow-up visits (87%) and compliance with stroke medication (84%). Distance and transportation (60%) were cited as the main barriers to care. After discharge, the majority preferred healthcare facilities close to their homes (60%).
This study emphasizes the need for stroke survivors to have follow-up and compliance with medication, along with various unmet needs such as de-addiction services, vocational training, and emotional support. A network-based multi-disciplinary approach, along with a comprehensive hub and spoke model of stroke management services, could help address these challenges and improve patient outcomes.
中风是一项重大的公共卫生和临床挑战，会导致严重的死亡率和残疾率。中风幸存者需要护理和支持，尤其是在中风后的关键3个月内，此时95%的功能性神经恢复会发生。为了估计首次中风患者在印度一家三级神经专科医院的病死率和残疾程度，评估他们感知到的护理需求、障碍和未满足的护理需求，并确定出院后（3个月时）的护理途径。
在[国家精神卫生和神经科学研究所]接受护理的患者中开展了一项横断面描述性研究。2022年9月1日至10月31日期间首次中风且CT扫描确诊的患者，于2022年11月1日至2023年3月31日期间接受了随访。使用一份经过预测试的半结构化问卷收集信息。使用STATA 16版进行描述性统计。
研究对象中的中风病死率为13.8%。几乎一半（49.09%）的患者有某种形式的残疾，其中40%有中度至重度残疾。大多数人认为需要进行随访（87%）以及遵从中风药物治疗（84%）。距离和交通（60%）被认为是护理的主要障碍。出院后，大多数人更喜欢离家近的医疗机构（60%）。
本研究强调中风幸存者需要进行随访和遵医嘱用药，同时还存在各种未满足的需求，如戒毒服务、职业培训和情感支持。基于网络的多学科方法，以及中风管理服务的综合中心辐射模式，有助于应对这些挑战并改善患者预后。
