الفهرس 
Quality Indicators and Patients’ characteristics in Relation to Early Outcome of Kasr-Al-Ainy Stroke Unit
AbstractOnly 14 pages are availabe for public view
 |  | from | 178 |  |  |
| | | from | 178 | | |
Abstract
Background: A wide variety of factors have been reported to influence stroke prognosis. Quality indicators serve as standards of care by which performance of individual hospitals is measured improve patient care.Objectives: To provide an up-to-date account of the clinical and demographic characteristics of patients with stroke & to measure quality indicators; both in relation to stroke early outcome. Methods: We analyzed a prospective hospital-based data. All patients with acute stroke admitted to Kasr Al-ainy stroke unit over a one year period were included. Clinical variables & quality indicators were studied in relation to early outcome. Early outcome was defined as disability at discharge assessed by modified Rankin score(mRs), in-hospital death. Also, factors affecting hospital length of stay were assessed. Results: We studied 242 patients with acute stroke,145 patients (59.9%) had poor outcome at discharge [mRs 3-6]. There were 36 (14.9%) in-hospital deaths. Median hospital stay was eight days. Stroke severity (high NIHSS score), low Gugging swallowing scale (GUSS) score, hypertension were independent predictors for more disability at discharge. Chest infection, bed sores, mRs on admission, hemorrhagic transformation were independent predictors for in-hospital mortality. Receiving rtpa shows significant association with good outcome. Mean door to needle time was 65 minutes while mean onset to needle time was 216.8 minutes. Low GUSS score was associated with increased risk of chest infection. Conclusion: Stroke severity, potentially modifiable risk factors and complications (as hypertension, respiratory infection and bedsores) are associated with an increased risk of poor early outcome. Dysphagia screening using GUSS scale can predict patients with higher risk of aspiration pneumonia after stroke. Performance regarding DNT (door to needle time) needed to be improved