Dados do Trabalho

Título

Profile of patients admitted to a Stroke Unit of a Tertiary Hospital and outcomes after a 3-month post-discharge follow-up

Resumo

Background: Stroke is a major public health issue that leads to elevated mortality and morbidity. Specialized hospital care and standardized protocols are crucial in minimizing disability and intrahospital complications. Stroke Units (SU) provide the best multi-professional care, leading to reduced hospital stay length and adverse outcomes for these patients.
Objective: To describe the profile of inpatients of a SU in a Tertiary Hospital and functional outcome after a period of 3-month follow-up post-discharge.
Methods: This is a single-center, retrospective study of inpatients admitted to a SU in a Tertiary Center during 2020, which received standardized multi-professional health care. Fifty-nine individuals with hemorrhagic or ischemic stroke were enrolled. The following data were assessed: chemical thrombolysis with Alteplase (rtPA), thrombolytic door-to-needle time (DNT), the prevalence of major adverse outcomes due to rtPA, NIH Stroke Scale (NIHSS) at hospital admission, NIHSS at SU admission, NIHSS at discharge length of hospital stay, the prevalence of adverse outcomes during the hospital stay, functional status through modified Rankin Scale (mRS) at hospital discharge and after 3 months of discharge, through a remote assessment by telephone call.
Results: Mean age was 65,7±18 years, and 52% were women. Six patients (10,1%) were diagnosed with hemorrhagic stroke and 53 (89,9%) with ischemic stroke, which included 6 individuals with wake-up stroke. Among the ischemic stroke group, 19 (35,8%) received rtPA, with a mean DNT of 47 +18 minutes, and none had hemorrhagic transformation or anaphylaxis. Median NIHSS was 7 at hospital admission, 3 at SU admission, and 2 at discharge. Regarding adverse outcomes during the hospital stay, 1 patient (1,6%) deceased, 8 (13,5%) had pneumonia, none had DVP or pressure ulcers. The mean length of hospital stay was 7,5. Mean mRS at hospital discharge was 02. After a 3-month period post-discharge, 44 patients were reassessed and 30 (68,2%) individuals had mRS 0-2, 8 (18,2%) had mRS 3-5 and 6 (13,6%) had mRS 6 by any cause.
Discussion: SU and standardized multi-professional health care might benefit stroke patients and reduce the length of hospital stay and adverse outcomes. Our data regarding a Brazilian SU stroke are in alignment with previous international data.

Palavras Chave

Stroke Unit