Pusat Pengajian Sains Perubatan - Tesis

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Browsing Pusat Pengajian Sains Perubatan - Tesis by Subject "Acute ischemic stroke"

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    A comparison of prevalence, clinical management and treatment outcome of ischemic stroke prior to and during covid-19 pandemic in Hospital Universiti Sains Malaysia
    (2022)
    Suliman, Ayman Sirelkhatim Ali
    Introduction Ischemic stroke is a medical emergency. Risk of poor outcomes in stroke increases with delay in time to treatment. Covid-19 pandemic had a significant impact on stroke management resulting in more severe stroke. This study aims to determine the impact of Covid-19 pandemic on the total number of ischemic stroke patients admissions, stroke standards of care and outcome. Methodology This is a retrospective record review study. Data of patients with radiologically or clinically confirmed AIS in HUSM diagnosed from 1st March 2019 until 28th February 2021 were included. Results A total of 229 patients were included; 114 (49.8%) patients in the pre -covid-19, and 115 (50.2%) patients during covid-19. Initial NIHSS score was similar, 5.3 ± (4.18) in 2019 and 5.9 ± (4.42) in 2020. Onset to door time in minutes was 1875.2(2034.72) in pre- Covid-19 vs 1827.1(2163.95) in Covid-19 group (t. test 0.17 p-value 0.863). Time to see emergency doctor in minutes was 25.3 (30.21) in pre covid-19 vs 22.6(16.48) in Covid- 19 group (t. test .48 p-value 0.402). Door to CT brain time in minutes 83.8 (58.91) vs 92.4 (120.20) in pre-covid-19 and Covid-19 group subsequently (t. test -.69 p- value 0.493). For patients received thrombolytic therapy; 7(6.1%) pre covid-19 vs. 4 (3.5%) during covid-19 period (p-value>0.5). Other stroke metrics including physiotherapy,occupational therapy, speech therapy assessment and dietician, results were ;(77.2% vs 81.7% p-value >.05) (76.3% vs 81.7% p-value >.05) (50% vs 59.1% p- value>.05) (43.9% vs45.2% p-value>.05) for physiotherapy, occupational therapy, speech therapy and dietician subsequently. For treatment outcome, duration of hospital stay was [(6.4 ± 4.5 vs. 7.56.74) (t. test - 1.36, p-value0.175)] in pre Covid-19 and during covid-19 respectively. While MRS score at discharge was [(2.8(1.38) vs. 2.9(1.49) (t. test .33 p- value 0.742)] in pre -Covid-19 and during Covid-19 respectively. Conclusion Covid-19 had no significant impact on stroke management in HUSM. Comparison of stroke risk factors, subtypes and severity, door to needle time and onset to needle time for thrombolysis were statistically insignificant. Stroke management outcomes were similar for MRS score, duration of hospitalization, hospital acquired infection and 7 days mortality