Predictors of medical complications in stroke patients confined in hospitals with rehabilitation facilities: A Filipino audit of practice
- Author:
Consuelo B Gonzalez-Suarez
1
;
Consuelo B Gonzalez-Suarez
2
;
Karen Grimmer
3
;
Jan-Tyrone C Cabrera
1
;
Isaias P Alipio
4
;
Elda Grace G Anota-Canencia
5
;
Maria Luisa P Santos-Carpio
6
;
Janine Margarita R Dizon
2
;
Lauren Liao
7
;
Romil Martinez
8
;
Eulalia J Beredo
9
;
Carolina M Valdecaňas
10
,
11
;
Vania Yu
10
,
11
Author Information
1. Department of Physical Medicine and Rehabilitation
2. Centre for Health Research and Movement Science, University of Santo Tomas, Manila, Philippines
3. Stellenbosch University, Cape Town, South Africa
4. Department of Medicine, Rehabilitation Medicine Unit, Mariano Marcos Memorial Hospital and Medical Center, Batac, Ilocos Norte
5. Department of Physical Medicine and Rehabilitation, Chong Hua Hospital, Cebu City
6. Physical Medicine and Rehabilitation Center, Davao Medical School Foundation, Davao City
7. 1 Lauren Liao
8. Department of Rehabilitation Medicine, Amang Rodriguez Medical Center, Marikina City, Rizal
9. 8 Department of Rehabilitation Medicine, Philippine Orthopedic Center, Quezon City
10. St. Luke&rsquo
11. s Medical Center, Quezon City, Philippines
- Publication Type:Journal Article
- Keywords:
Audit;
clinical practice guideline;
medical complications;
pneumonia;
stroke
- From:Neurology Asia
2018;23(3):199-208
- CountryMalaysia
- Language:English
-
Abstract:
Most medical complications following acute stroke are preventable (such
as cardiac events, pneumonia, bed sores and venous thrombosis). This was a study on the frequency
of medical complications and their association with key performance indicators. Methods: The study
used a cross-sectional baseline audit of stroke care practices. The audit captured details on the nature
of the stroke, patient demographics, characteristics of hospital care, and compliance with six key
quality indicators in Philippine Academy of Rehabilitation Medicine Clinical Practice Guideline on
Stroke Rehabilitation. Patient records were retrospectively consecutively sampled. Results: A total
of 1,683 patients were included in the audit which came from 49 hospitals. Medical complications
were seen in 182 patients (11.2%). Pneumonia contributed to half the medical complications (50%),
followed by respiratory failure (7.7%) and gastrointestinal bleeding (3.8%). Presence of medical
complications were associated with in-patient mortality (OR 3.3 (95% CI 2.1-5.3)) and prolonged
hospital stay (16.1 ± 20.7 days vs 9.6 + 10.9 days). The best predictor model for pneumonia included
variables of not having a swallow screen within the first 24 hours, having a nasogastric tube inserted,
not achieving medical stability, not having a stroke unit in the admitting hospital, having suffered a
previous stroke and being older.
Conclusion: Non-adherence to evidence-based stroke care rehabilitation guidelines contributed
significantly to medical complications in an audit of Filipino stroke patients
- Full text:7.2018.my001.pdf
