2020, Number 3
Stroke in geriatric patients admitted to the intermediate care of internal medicine
Language: Spanish
References: 34
Page:
PDF size: 607.25 Kb.
ABSTRACT
Introduction: The knowledge and control of the stroke patient can contribute to improve the prognosis.Objective: To characterize geriatric patients with stroke, who enter the intermediate care unit of medicine.
Methods: an observational and cross-sectional study was carried out, in geriatric patients admitted with stroke, in the medicine intermediate care room of the Hospital Militar Central Dr. Luis Díaz Soto. The universe was 680 patients with the clinical and imaging diagnosis of stroke. Variables studied were: age, sex, clinical forms, NIHSS indexes, personal pathological history, morbidity, lethality, and dependency status.
Results: The ischemic form predominated (94%), the age from 65 to 74 years (40%), the male sex (61.5%) and the NIHSS index less than 20 points (82.7%). High blood pressure, previous cerebrovascular disease and diabetes mellitus were the most frequent antecedents. The lethality was 10.0% and the most frequent complication was bronchopneumonia (16.9%). 40% presented a state of total dependency.
Conclusions: Patients were characterized by the predominance of the ischemic form, of the male sex, age between 70 and 79 years, and bronchopneumonia as a complication. The high NIHSS index was associated with an unsatisfactory evolution and although the overall case fatality was not high, the presence of the state of total dependence was important. This requires significant rehabilitation work to achieve an acceptable quality of life.
REFERENCES
Ceballos Ortiz JM, Morín Martín MM, Garrido Robres JA. Accidente cerebrovascular agudo en urgencias. En: Julián Jiménez A, Aguilar Florit J, Blanco Bravo A, Buitrago Sivianes S, Cañete Palomo M, Chacón Martínez J, editores. Manual de Protocolos y Actuación en Urgencias.4ta Edición. Toledo: Edición patrocinada por SANOFI. Reimpresión; 2016. p. 557-66.
Smith EE, Saposnik G, Biessels GJ, Doubal FN, Forna M, Gorelick PB, et al. Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017[acceso: 20/07/2018];48(2):e44-e71. Disponible en: https://www.ahajournals.org/doi/pdf/10.1161/str.0000000000000116
Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotto JC, et al. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke. 2016 acceso: 28/04/2017;47(2):581-641. Disponible en: https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000086-?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub-%3dpubmed
Nakao S, Takata S, Vemura H, Kashihara M, Osawa T, Komatsu K, et al. Relation between Barthel index score during the acute phase of rehabilitation and subsecuent ADL in stroke patient. The Journal of Medical Investigation. 2010 [acceso: 20/02/2016];57(1-2):81-8. Disponible en: https://www.researchgate.net/profile/Hirokazu_Uemura/publication/42345331_Relationship_between_Barthel_-Index_scores_during_the_acute_phase_of_rehabilitation_and-_subsequent_ADL_in_stroke_patients/links/02bfe-513fbe1134ead000000/Relationship-between-Barthel-Index-scores-during-the-acute-phase-of-rehabilitation-and-subsequent-ADL-in-stroke-patients.pdf
Molina Nieto T, Calvo Rodríguez R, Ochoa Sepúlveda JJ, Jiménez Murillo L, Castilla Camacho S, Montero Pérez FJ, et al. Accidente cerebrovascular. En: Jiménez Murillo L, Montero Pérez FJ, editores. Medicina de urgencias y emergencias. Guía diagnóstica y protocolos de actuación. 5ta ed. Barcelona: Editorial Elsevier; 2015.p 387-96.
Piloto González R, Herrera Miranda GL, Ramos Águila Y, Mujica González DB, Gutiérrez Pérez M. Caracterización clínica-epidemiológica de la enfermedad cerebrovascular en el adulto mayor. Rev Ciencias Médicas Pinar del Río. 2015 [acceso: 10/12/2015];19(6):[aprox. 10 p.]. Disponible en: https://revcmpinar.sld.cu/index.php/publicaciones/article/view/231-6/html_146
Cayuela A, Cayuela L, Escudero-Martínez I, Rodríguez-Dominguez S, González A, Moniche F, et al. Análisis de las tendencias en la mortalidad por enfermedades cerebrovasculares en España 1980-2011. Neurología. 2016[acceso: 21/03/2017]; 31(6):370-8. Disponible en: https://www.sciencedirect.com/science/article/pii/S0213485314001790
Sodhi K, Singla MK, Shrivastava A, Bansal N. Do Intensive Care Unit treatment modalities predict mortality in geriatric patients: An observational study from an Indian Intensive Care Unit. Indian J Crit Care Med. 2014[acceso: 17/06/2016];18(12):789-95. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271278/
Escobar Alfonso V, Zaldívar Garit M, Rodríguez de la Rosa G, Cabrera Cordobés JC. Factores de riesgos prevalentes en pacientes ingresados por enfermedad cerebrovascular. Rev Cub Med Mil. 2014 [acceso: 23/10/2015];43(4):[aprox. 9 pant.]. Disponible en: https://scielo.sld.cu/scielo.php? script=sci_arttext&pid=S0138-65572014000400003
Díaz Alfonso H, Sparis Tejido M, Carbó Rodríguez HL. Ictus isquémico en pacientes hospitalizados con 50 años o más. Rev de Ciencias Médicas de Pinar del Río. 2015 [acceso: 18/01/2016];19(6):[aprox. 8 pant.]. Disponible en: https://www.revcmpinar.sld.cu/index.php/publicaciones/article/view/-2303/html_152
Strachinariu RT. The role of endothelial dysfunction in the pathogenesis of vascular complications of diabetes mellitus - a high priority area of investigation. Rom J Diabetes Nutr Metab Dis. 2015[acceso: 06/02/2016].22(1):61-6. Disponible en: https://www.degruyter.com/downloadpdf/j/rjdnmd.2015.22.issue-1/rjdnmd-2015-0008/rjdnmd-2015-0008.xml
Claude Hemphill J, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al. American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Clinical Cardiology. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke. 2015 acceso: 15/02/2016;46:2032-60. Disponible en: https://stroke.ahajournals.org/content/46/7/2032.full
Iglesias Mohedano AM, García Pastor A, Villanueva Osorio JA, Gil Núñez AC. Protocolos de práctica asistencial: Protocolo de atención del ictus en Urgencias. Medicine-Programa de Formación Médica Continuada Acreditado. 2015[acceso: 07/03/2016];11(89):5337-42. Disponible en: https://www.sciencedirect.com/science/article/pii/S0304541215002875
Vila García LO, Hernández Pedroso W, Castillo López B, Ramos Ravelo D, Lemer Rodríguez A, Santana Sánchez R. Caracterización de los factores modificables asociados a la letalidad hospitalaria del ictus. Rev Cub Med Mil. 2017 [acceso: 03/06/2018];46(2):160-73. Disponible en: https://www.revmedmilitar.sld.cu/index.php/mil/article/view/37/52
Pérez García AR, García Montero A, Sosa Acosta EF, Padrón Valdés F. Factores pronósticos de mortalidad por hemorragia intracerebral en el periodo agudo. Rev Cub Med Mil. 2015[acceso: 03/03/2016];44(3):[aprox. 11 p.]. Disponible en: https://scielo.sld.cu/scielo.php?pid=S0138-65572015000300002&script=sci_arttext&tlng=pt
Mohanty CS, Ray S, Singhal A. Relationship between Barthel Index (BI) and the Modified Rankin Scale (mRS) Score in Assessing Functional Outcome in Acute Ischemic Stroke. Journal of Marine Medical Society. 2016 acceso: 27/01/2017;18(2):144-9. Disponible en: https://www.marinemedicalsociety.in/temp/JMarMedSoc182144-6766277_184742.pdf
Fujita T, Sato A, Yamamoto Y, Yamane K, Otsuki K, Tsuchiya K, et al. Relationship between dressing and motor function in stroke patients: a study with partial correlation analysis. J Phys Ther Sci . 2015[acceso: 17/09/2017];27(12):3771-4. Disponible en: https://www.jstage.jst.go.jp/article/jpts/27/12/27_jpts-2015-632/_pdf