Raspodjela rizičnih čimbenika za moždani udar u istočnoj Hrvatskoj

The aim of this study was to determine the distribution of risk factors according to age, gender, subtypes and recurrence of stroke in eastern Croatia. The study included 250 acute stroke patients admitted to University Department of Neurology, Osijek University Hospital Centre in 2011. Patients were grouped according to age, gender, subtypes and recurrence of stroke. The study showed significant differences in the distribution of cigarette smoking, diabetes, cardiomyopathy and hyperuricemia according to patient age. According to gender, male patients had a significantly higher prevalence of smoking and alcohol abuse, whereas in female patients the prevalence of arterial hypertension, atrial fibrillation and hyperuricemia was significantly higher. Regarding stroke subtypes, significant differences were noticed in the prevalence of arterial hypertension, atrial fibrillation, cardiomyopathy and cerebral blood vessel stenosis. Atrial fibrillation was significantly more common in first-ever than in recurrent stroke. Study results identified the groups of patients requiring special attention regarding particular risk factors in eastern Croatia and emphasized the need of developing regional strategies of screening, prevention and holistic care for stroke patients.Cilj ovoga istraživanja bio je odrediti raspodjelu rizičnih čimbenika u bolesnika s moždanim udarom u istočnoj Hrvatskoj prema dobi, spolu, podtipovima i ponovnom javljanju. U istraživanje bilo je uključeno 250 bolesnika koji su pretrpjeli akutni moždani udar i primljeni su na Kliniku za neurologiju Kliničkoga bolničkog centra Osijek u 2011. godini. Bolesnici su podijeljeni prema dobi, spolu, podtipovima i ponovnom javljanju. Istraživanje je pokazalo značajne razlike u raspodjeli pušenja cigareta, dijabetesa, kardiomiopatije i hiperuricemije prema dobi bolesnika. Prema spolu, učestalost pušenja i zlouporabe alkohola bila je značajno veća kod muških bolesnika, dok je učestalost arterijske hipertenzije, atrijske fibrilacije i hiperuricemije bila značajno veća kod žena. Prema podtipovima moždanog udara, značajne razlike uočene su kod učestalosti arterijske hipertenzije, atrijske fibrilacije, kardiomiopatije i stenoze cerebralnih krvnih žila. Atrijska fibrilacija bila je značajno češća u prvom nego u ponovljenom moždanom udaru. Naši rezultati pokazuju koje skupine bolesnika u istočnoj Hrvatskoj zahtijevaju posebnu pozornost s obzirom na pojedine rizične čimbenike te naglašavaju potrebu osmišljavanja regionalnih strategija za probir, prevenciju i holističku brigu za oboljele od moždanog udara

Quality of Life of Patients after Stroke in County Osijek-Baranya

The purpose of this prospective study was to determine quality of life of patients after stroke in Osijek-Baranya County. The research included 161 patients (82 men and 79 women) who had their first acute stroke and were treated at Department of Neurology, Osijek University Hospital Center. The Barthel Index (BI) was used to assess functional deficiency and SS-QOL (Stroke-Specific Quality of Life) questionnaire was used for self-evaluation of patients’ physical and mental health. The first assessment was carried out in the acute phase of the disease, and control assessments 30, 90 and 180 days after the stroke. Mean Barthel Index score was higher at every successive measurement (55, 80, 95, 95). All BI items were statistically significant (Friedman, p<0.001) apart from dressing and bowel control. BI score indicated greater dependence in women in all assessments except for those taken 90 days after onset of symptoms (c2-test, p=0.111). Mean values of SS-QOL for physical health were: 105.2, 98.3, 105.7, 117.5 and for mental health: 64.24, 57.9, 64.3, 68.1. Statistically significant difference was present in men, both for physical health (Friedman p=0.009) and total SS-QOL (Friedman p=0.014), while in women there was no statistically significant difference between the measurements (Friedman p=0.719). The research showed that stroke has significant influence on basic and specific daily life activities and interferes with the quality of life of stroke patients. Women have lower level of independence. Patients who live with their families make better evaluation of their physical and mental health

Outcome of different stroke subtypes

Cilj: odrediti pokazatelje kratkoročnoga ishoda različitih podvrsta moždanoga udara. Metode: opservacijska, prospektivna, kohortna studija. Obuhvaćena je grupa od 130 bolesnika. Korištena klasifikacija za hemoragijski moždani udar: intracerebralna hemoragija i subarahnoidalna hemoragija; za ishemijski moždani udar: TOAST (Trial of ORG 10172 in Acute Stroke Treatment) klasifikacija. Stupanj onesposobljenosti procijenjen je uz pomoć modificirane Rankin skale. Rezultati: najčešća komplikacija moždanoga udara bila je uroinfekcija. Ispitanici s moždanim udarom malih krvnih žila imali su najmanje komplikacija, najmanji funkcionalni deficit i smrtnost, a ispitanici s intracerebralnom hemoragijom imali su najviše komplikacija, najveći funkcionalni deficit i smrtnost. Zaključak: rezultati potvrđuju varijacije u ishodu različitih podvrsta moždanoga udara.Aim: To determine indicators of short-term outcome of different stroke subtypes. Methods: An observational prospective cohort study. Group of 130 patients was studied. Classification used: Hemorrhagic stroke (Intracerebral hemorrhage (ICH), Subarachnoid hemorrhage (SAH)); Ischemic stroke: TOAST (Trial of ORG 10172 in Acute Stroke Treatment) classification. Degree of disability was assessed using the Modified Rankin Scale. Results: The most common stroke complication was urinary infection. Patients with small vessel stroke had the lowest rate of complications, functional deficit and case-fatality and patients with ICH had the highest rate of these indicators. Conclusion: Results confirm variations of outcome in different stroke subtype

Time of delay of stroke patients in Osijek region

Trombolitička terapija poboljšava ishod moždanoga udara (MU) kada se primijeni unutar 3 sata od nastupa simptoma. Cilj istraživanja bio je utvrditi koliko je prosječno vrijeme kašnjenja (VK) bolesnika na osječkom području. Prospektivno je bilježeno VK u 100 bolesnika liječenih na Klinici za neurologiju KBC Osijek. Prosječno je VK 502 minute. Unutar 3 sata stiglo je 53%, unutar 6 sati 66%, unutar 12 sati 79% i unutar 24 sata 90% oboljelih. Stanje još uvijek nije zadovoljavajuće i nužno je daljnje informiranje stanovništva i edukacija o simptomima MU-a.Thrombolytic therapy improves the outcome after ischemic stroke when applied within 3 hours from symptoms onset. The goal of study was to investigate the time of delay for acute stroke patients (pts) treated at Neurology clinic, University Hospital Centre Osijek. The mean time of delay was 502 minutes. 53% of pts arrived within 3 hours, 66% within 6 hrs, 79% within 12 hrs and 90% of pts within 24 hours. The situation is not yet satisfying and efforts to reduce time of delay and to educate population are necessary

Quality of Life of Patients after Stroke in County Osijek-Baranya

The purpose of this prospective study was to determine quality of life of patients after stroke in Osijek-Baranya County. The research included 161 patients (82 men and 79 women) who had their first acute stroke and were treated at Department of Neurology, Osijek University Hospital Center. The Barthel Index (BI) was used to assess functional deficiency and SS-QOL (Stroke-Specific Quality of Life) questionnaire was used for self-evaluation of patients’ physical and mental health. The first assessment was carried out in the acute phase of the disease, and control assessments 30, 90 and 180 days after the stroke. Mean Barthel Index score was higher at every successive measurement (55, 80, 95, 95). All BI items were statistically significant (Friedman, p<0.001) apart from dressing and bowel control. BI score indicated greater dependence in women in all assessments except for those taken 90 days after onset of symptoms (c2-test, p=0.111). Mean values of SS-QOL for physical health were: 105.2, 98.3, 105.7, 117.5 and for mental health: 64.24, 57.9, 64.3, 68.1. Statistically significant difference was present in men, both for physical health (Friedman p=0.009) and total SS-QOL (Friedman p=0.014), while in women there was no statistically significant difference between the measurements (Friedman p=0.719). The research showed that stroke has significant influence on basic and specific daily life activities and interferes with the quality of life of stroke patients. Women have lower level of independence. Patients who live with their families make better evaluation of their physical and mental health

Outcome of different stroke subtypes

Cilj: odrediti pokazatelje kratkoročnoga ishoda različitih podvrsta moždanoga udara. Metode: opservacijska, prospektivna, kohortna studija. Obuhvaćena je grupa od 130 bolesnika. Korištena klasifikacija za hemoragijski moždani udar: intracerebralna hemoragija i subarahnoidalna hemoragija; za ishemijski moždani udar: TOAST (Trial of ORG 10172 in Acute Stroke Treatment) klasifikacija. Stupanj onesposobljenosti procijenjen je uz pomoć modificirane Rankin skale. Rezultati: najčešća komplikacija moždanoga udara bila je uroinfekcija. Ispitanici s moždanim udarom malih krvnih žila imali su najmanje komplikacija, najmanji funkcionalni deficit i smrtnost, a ispitanici s intracerebralnom hemoragijom imali su najviše komplikacija, najveći funkcionalni deficit i smrtnost. Zaključak: rezultati potvrđuju varijacije u ishodu različitih podvrsta moždanoga udara.Aim: To determine indicators of short-term outcome of different stroke subtypes. Methods: An observational prospective cohort study. Group of 130 patients was studied. Classification used: Hemorrhagic stroke (Intracerebral hemorrhage (ICH), Subarachnoid hemorrhage (SAH)); Ischemic stroke: TOAST (Trial of ORG 10172 in Acute Stroke Treatment) classification. Degree of disability was assessed using the Modified Rankin Scale. Results: The most common stroke complication was urinary infection. Patients with small vessel stroke had the lowest rate of complications, functional deficit and case-fatality and patients with ICH had the highest rate of these indicators. Conclusion: Results confirm variations of outcome in different stroke subtype

Time of delay of stroke patients in Osijek region

Trombolitička terapija poboljšava ishod moždanoga udara (MU) kada se primijeni unutar 3 sata od nastupa simptoma. Cilj istraživanja bio je utvrditi koliko je prosječno vrijeme kašnjenja (VK) bolesnika na osječkom području. Prospektivno je bilježeno VK u 100 bolesnika liječenih na Klinici za neurologiju KBC Osijek. Prosječno je VK 502 minute. Unutar 3 sata stiglo je 53%, unutar 6 sati 66%, unutar 12 sati 79% i unutar 24 sata 90% oboljelih. Stanje još uvijek nije zadovoljavajuće i nužno je daljnje informiranje stanovništva i edukacija o simptomima MU-a.Thrombolytic therapy improves the outcome after ischemic stroke when applied within 3 hours from symptoms onset. The goal of study was to investigate the time of delay for acute stroke patients (pts) treated at Neurology clinic, University Hospital Centre Osijek. The mean time of delay was 502 minutes. 53% of pts arrived within 3 hours, 66% within 6 hrs, 79% within 12 hrs and 90% of pts within 24 hours. The situation is not yet satisfying and efforts to reduce time of delay and to educate population are necessary