THE PRESENTATION OF MEDICAL COMPLICATIONS IN THE ACUTE IN-HOSPITAL MANAGEMENT OF STROKE PATIENTS AND THEIR DETERMINANTS: A CROSS-SECTIONAL STUDY

Abstract

Objectives: To find the frequency of Acute Medical complications and their determinants in stroke patients admitted to a hospital in Peshawar. Materials and Methods: In this cross-sectional descriptive study in the Department of Medicine and Neurology at Hayat Abad Medical Complex, Peshawar, Pakistan from 1/10/2022 till 31/12/2022, a total of 180 patients who presented with Cerebrovascular events based on CT/MRI were included. Patients’ data were collected through questionnaires, NIHSS and GCS scores were calculated at the presentation and patients were followed in the hospital to detect complications. Comparisons with p-values were then determined using SPSS. Results: The overall rate of stroke complications in 180 patients documented was 90%, the common being Aspiration Pneumonia (48.89%), Urinary Tract infections (30%), Bedsores (28.33%), Pyrexia illness (22.22%) and Seizures (12.78%). NIHSS scores had a direct relationship, with patients scoring >12 having a complications rate of 93% in contrast to 76.5% in patients with scores of ?3 (p-value 0.032). GCS at presentation had similar predictive value with scores of 15/15 having 73% and ?8 having a 91% complication rate. Duration of hospitalization (p-value 0.014) had a key impact as patients admitted for a month had higher percentages of complications primarily UTI (52.4%), Bedsores (71%), and Constipation (33.3%). Treatments like Dexamethasone (p-value 0.003) and antiplatelets (p-value 0.010) were found to increase the rate of complications. Conclusion: In-hospital post-stroke complications are common having a direct link with stroke severity, hospitalization duration, and treatment given. An active approach is needed to identify and treat any complications early, thereby, improving outcomes and decreasing morbidity. Keywords: Stroke, Complications, in-hospital management