Factors Influencing Early Neurological Recovery in Patients with Acute Ischemic Stroke

Authors

  • Orapen SUKHAVULLI Department of Surgery Nursing, Faculty of Nursing, Mahidol University, Nakhon Pathom 73170
  • Siriorn SINDHU Department of Surgery Nursing, Faculty of Nursing, Mahidol University, Nakhon Pathom 73170
  • Wanpen PINYOPASSAKUL Department of Surgery Nursing, Faculty of Nursing, Mahidol University, Nakhon Pathom 73170
  • Chukiat VIWATWONGKASEM Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok 10400

DOI:

https://doi.org/10.48048/wjst.2019.4063

Keywords:

Early neurological recovery, acute ischemic stroke, onset time to rt-PA

Abstract

The purposes of this cross-sectional descriptive study were to describe early neurological recovery in patients with acute ischemic stroke and to identify the statistical predictors of early neurological recovery at 24 h and 3 days after admission. A purposive random sampling was employed to recruit 220 AIS patients from 8 hospitals in the southern region of Thailand from January to May 2016, and the data was analyzed by using multivariate logistic regression analysis. The results revealed that moderate and severe stroke severity decreased neurological recovery at 24 h (OR = .095, p < .001, and OR = .126, p < .01, respectively), compared with mild stroke severity. In addition, onset time to rt-PA within 3 h and 3.0 - 4.5 h increased the neurological recovery at 24 h (OR = 22.22, P < .001, and OR = 17.28, P < .01, respectively), compared with those who did not receive rt-PA treatment. Lastly, age > 80 years decreased neurological recovery at 24 h after admission (OR=.361, P < .05). Neurological recovery at 3 days showed that moderate and severe stroke severity decreased neurological recovery (OR = .10, p < .001, and OR = .09, p < .001, respectively), compared with mild stroke severity. Stroke patients who had onset time to rt-PA within 3 h and within 3.0 - 4.5 h increased neurological recovery at 3 days (OR=16.95, P < .05, and OR = 14.43, P < .01, respectively), compared with those who did not receive rt-PA treatment. The findings of this study show that stroke severity and onset time to rt-PA influence early neurological recovery in AIS patients.

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Author Biography

Orapen SUKHAVULLI, Department of Surgery Nursing, Faculty of Nursing, Mahidol University, Nakhon Pathom 73170

Faculty of Nursing, Mahidol University, Thailand

References

AG Thrift, DA Cadilhac, T Thayabaranathan, G Howard, VJ Howard, PM Rothwell, VL Feigin, B Norrving, GA Donnan and DA Cadilhac. Global stroke statistics. Int. J. Stroke 2014; 9, 870-947.

K Strong, C Mathers and R Bonita. Preventing stroke: Saving lives around the world. Lancet Neurol. 2007; 6, 182-7.

S Hanchaiphiboolkul, N Poungvarin, S Nidhinandana, N Suwanwela, P Puthkhao, S Towanabut, T Tantirittisak, J Suwantamee and M Samsen. Prevalence of stroke and stroke risk factors in Thailand: Thai Epidemiologic Stroke (TES) study. J. Med. Assoc. Thai. 2011; 94, 427-36.

JR Marler, BC Tilley, M Lu, TG Brott, PC Lyden, JC Grottaet, JP Broderick, SR Levine, MP Frankel, SH Horowitz, ECJ Haley, CA Lewandowski and TP Kwiatkowski. Early stroke treatment associated with better outcome: The NINDS rt-PA stroke study. Neurology 2000; 55, 1649-55.

O Khiaocharoen, S Pannarunothai, W Riewpaiboon, L Ingsrisawang and Y Teerawattananon. Economic evaluation of rehabilitation services for inpatients with stroke in Thailand: A prospective cohort study. Value Health Reg. Issues 2012; 1, 29-35.

IP Muresan, P Favrole, P Levy, F Andreux, B Marro and S Alamowitch. Very early neurologic improvement after intravenous thrombolysis. Arch. Neurol. 2010; 67, 1323-8.

JF Hair, WC Black, BJ Babin and RE Anderson. Multivariate Data Analysis. Pearson Education, New Jersey, 2010.

M Mazighi, H Meseguer, J Labreuche, JM Serfaty, JP Laissy, PC Lavallee, L Cabrejo, C Guidoux, B Lapergue, IF Klein, JM Olivot, A Rouchaud, JP Desilles, E Schouman-Claeys and P Amarenco. Dramatic recovery in acute ischemic stroke is associated with arterial recanalization grade and speed. Stroke 2012; 43, 2998-3002.

C Weimar, C Weber, M Wagner, O Busse, RL Haberl, KW Lauterbach and HC Diener. Management patterns and health care use after intracerebral hemorrhage: A cost-of-illness study from a societal perspective in Germany. Cerebro. Dis. 2003; 15, 29-36.

MC Tseng and KC Chang. Stroke severity and early recovery after first-ever ischemic stroke: Results of a hospital-based study in Taiwan. Health Pol. 2006; 79, 73-8.

PS Reynolds, CT Crenshaw, DS Lefkowitz, BJ Shelton, JS Preisser and CH Tegeler. A practical stroke severity scale predicts hospital outcomes. J. Stroke Cerebro. Dis. 2001; 10, 231-5.

KR Lees, E Bluhmki, R Kummer, TG Brott, D Toni, JC Grotta, GW Albers, M Kaste, JR Marler, SA Hamilton, BC Tilley, SM Davis, GA Donnan, W Hacke, K Allen, J Mau, D Meier, GD Zoppo, DAD Silva, KS Butcher, MW Parsons, PA Barber, C Levi, C Bladin and G Byrnes. Time to treatment with intravenous alteplase and outcome in stroke: An updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet 2010; 375, 1695-703.

MG Lansberg, M Schrooten, E Bluhmki, VN Thijs and JL Saver. Treatment time-specific number needed to treat estimates for tissue plasminogen activator therapy in acute stroke based on shifts over the entire range of the modified Rankin Scale. Stroke 2009; 40, 2079-84.

C Kugler, T Altenhoner, P Lochner and A Ferbert. Does age influence early recovery from ischemic stroke? A study from the Hessian Stroke Data Bank. J. Neurol. 2003; 250, 676-81.

CT Ong, SF Sung, CS Wu, YC Hsu, YH Su, CH Li and LC Hung. Early neurological improvement after intravenous tissue plasminogen activator infusion in patients with ischemic stroke aged 80 years or older. J. Chin. Med. Assoc. 2014; 77, 179-83.

EC Jauch, JL Saver, HP Adams, A Bruno, JJ Connors, BM Demaerschalk, P Khatri, PWJ McMullan, AI Qureshi, K Rosenfield, PA Scott, DR Summers, DZ Wang, M Wintermark and H Yonas. Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44, 870-947.

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Published

2018-04-09

How to Cite

SUKHAVULLI, O., SINDHU, S., PINYOPASSAKUL, W., & VIWATWONGKASEM, C. (2018). Factors Influencing Early Neurological Recovery in Patients with Acute Ischemic Stroke. Walailak Journal of Science and Technology (WJST), 16(12), 931–941. https://doi.org/10.48048/wjst.2019.4063