1.Predictors of medical complications in stroke patients confined in hospitals with rehabilitation facilities: A Filipino audit of practice
Consuelo B Gonzalez-Suarez ; Consuelo B Gonzalez-Suarez ; Karen Grimmer ; Jan-Tyrone C Cabrera ; Isaias P Alipio ; Elda Grace G Anota-Canencia ; Maria Luisa P Santos-Carpio ; Janine Margarita R Dizon ; Lauren Liao ; Romil Martinez ; Eulalia J Beredo ; Carolina M Valdecaňas ; Vania Yu
Neurology Asia 2018;23(3):199-208
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
Result Analysis
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