Preditores de internação prolongada em Unidade de Acidente Vascular Cerebral (AVC)

Abstract

Objective to analyze the in-hospital complications of prolonged hospital stay in patients with ischemic stroke or transient ischemic attack, admitted to the stroke unit of a tertiary hospital.Method this is an evaluative correlational study. All first-ever ischemic stroke or transient ischemic attack patients admitted were retrospectively analyzed. During hospital stay, the predictors of long-term hospitalization considered were: 1) clinical complications (pneumonia, urinary tract infection, pressure damage and deep vein thrombosis), and 2) neurological complications (malignant ischemic stroke and symptomatic hemorrhagic transformation).Results 353 patients were discharged in the study period. Mean age was 64.1±13.7 years old and 186 (52.6%) were men. The mean time of hospital stay was 13.7±14.3 days. Pneumonia (25.3±28.8 days, p<0.001), urinary tract infection (32.9±45.2 days, p<0.001) and malignant stroke (29.1±21.4 days, p<0.001) increased significantly the length of hospital stay compared to patients without any complications (11.2±7.1 days).Conclusion this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units.

The Riga East University Hospital Stroke Registry—An Analysis of 4915 Consecutive Patients with Acute Stroke

“…The most common complications that occurred in hospital were pneumonia (5.1%), followed by decompensation of congestive heart failure (4.9%) and severe kidney failure (2.2%). The reported in-hospital complication rates differed compared to those described in other studies: pneumonia (5.1% vs. 2.3–13.9%) and urinary tract infection (1.7% vs. 3.6–19%) [ 27 , 28 , 29 , 30 ]. The results from other reported studies may have resulted from differences in the standardization of complications, definition of complications, selection of patients, patient cohort size, time of evaluation, and follow-up time [ 28 , 30 ].…”

“…However, the proportion of patients who were receiving anticoagulants and statins was quite low (7.7% and 11.8%, respectively) [ 1 ]. Our data indicate a need to improve prevention and identify patients not treated with antihypertensive drugs, oral antidiabetics or insulin, statins, antiaggregants, and anticoagulants to reduce the conventional risk factors of acute IS [ 27 ].…”

Perfil Epidemiológico De Pacientes Internados Por Avc Em Belém-Pa Entre 2016 a 2020

“…Alguns estudos relatam que dentre os fatores de riscos para AVC, a idade avançada (maior que sessenta anos) está relacionada às maiores prevalências relacionadas a doenças cerebrovasculares, bem como aos piores desfechos no que diz respeito a tempo de internação, sequelas e óbitos. [28][29] Quadro 1: Distribuição da faixa etária dos pacientes internados por AVC durante o período de 2016 a 2020, em Belém do Pará.…”

Acidente Vascular Cerebral: caracterização clínica e desfechos Pós-alta

“…O tempo de permanência na hospitalização de pacientes com AVC pode estar relacionado a diversas variáveis, incluindo a gravidade do AVC, idade e comorbidades; complicações evitáveis, destacando-se a pneumonia e a infecção do trato urinário, bem como alguma complicação neurológica aumentam significativamente o tempo de permanência hospitalar em unidades de AVC; estes fatores demandam um programa de reabilitação mais intenso para sua recuperação (Gaspari et al, 2019).…”