Assessment of nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke

Abstract

Background/Aim. Stroke remains one of the leading causes of death and disability worldwide. The aim of the study was to determine the nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke (AIS) who were hospitalized at the Department of Emergency Neurology. Methods. Prospective cohort study included 59 consecutive patients with AIS admitted to the Department of Emergency Neurology, Neurology Clinic, Clinical Center of Serbia, Belgrade. The patients were followed until discharge or death. For exploring a relationship between the outcome of patients with AIS and different groups of factors, the univariate and multivariate Cox proportionate hazard regression models were used. Results. There were 32 male and 27 female patients with AIS. The mean age was 62.5 ? 15.2 years. The average duration of hospitalization was 11.1 ? 9.6 days (median 8 days; range 1?54 days). Almost 80% of patients (47/59; 79.7%) were admitted to the stroke unit, while 12 (20.3%) patients were admitted to the intensive care unit. In the univariate Cox regression analysis the significant variables (p < 0.05) were the Morse score (p = 0.030) and the type of admission unit (p = 0.029). The multivariate predictive model revealed that the type of admission unit (stroke unit vs conventional unit) [hazard ratio (HR) = 0.16; p = 0.032] was the independent predictor of in-hospital mortality in the patients with AIS. Conclusion. The results of this study showed an important role of nursing staff in the recovery of the AIS patients, as well as that admission to the stroke units versus the conventional units is the independent predictor of decreased in-hospital mortality. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175087]

Rol Enfermero en la Atención del Paciente con ICTUS en Entornos Hospitalarios

“…Además, se han investigado las experiencias y percepciones de las enfermeras en el cuidado de pacientes con ICTUS. Se ha observado que las enfermeras identifican una brecha entre su papel ideal en el cuidado y su práctica real, experimentando sentimientos encontrados que pueden afectar tanto psicológicamente como básicamente a las enfermeras [41,42,44] .…”

“…El principio enfatiza la urgente necesidad de detección y tratamiento tempranos en pacientes con sospecha de accidente cerebrovascular [10] . Es importante que las enfermeras puedan reconocer tempranamente las manifestaciones del ictus y determinar la aparición de los signos y síntomas para garantizar que los pacientes puedan recibir el tratamiento adecuado en un plazo determinado [11] . Según la Asociación Estadounidense del Corazón (AHA) y el Grupo de Consenso Europeo, los pacientes con ICTUS necesitan atención médica inmediata.…”

“…Semantic Scholar [42] Determinar los predictores de mortalidad intrahospitalaria asociados a los cuidados de enfermería en los pacientes con ICTUS isquémico agudo Los resultados evidencian mejoría de las características clínicas en pacientes con ICTUS tras la atención de enfermería en los aspectos: presión arterial, temperatura, frecuencia del pulso, saturación de oxígeno, glucemia, plaquetas, INR, Se demostraron un papel importante del personal de enfermería en la recuperación de los pacientes, así como el ingreso en las unidades de ICTUS frente a las unidades convencionales es el predictor independiente de disminución de la mortalidad hospitalaria. Zhang, J., Gu, L., Xu, Y., Zhao, B., Li, D., & Xiao, C. 2022 -China Semantic Scholar [43] Mejorar el tratamiento clínico y la calidad de la enfermería de pacientes con ICTUS agudo.…”

Nursing Care for Stroke Patients: Current Practice and Future Needs

“…Furthermore, the use of several stroke scales can also be beneficial to detect stroke manifestations and assess the severity of a stroke [ 8 ]. Several studies have suggested that the National Institutes of Health Stroke Scale (NIHSS) is effective, and it is widely used, easy to learn, and rapidly completed on admission.…”

“…According to previous studies on the early management of patients with stroke, one of the important members of the stroke-management team is the nursing staff [ 8 ]. Stroke nurses are well prepared to provide urgent care for stroke patients.…”