Spectrum of Medical Complications During Stroke Rehabilitation and its Associated Risk Factors
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Abstract
Background
Incidence of stroke is persistently increasing followed by effective medical treatment resulting in high number of stroke survivors. Post stroke recovery is critical necessitating sufficient knowledge, effective prevention and control of chronic diseases, pre-existing complications, and potential risk factors.
Objective
This study aimed to identify and evaluate potential risks and prognostic factors that can negatively influence post stroke rehabilitation in order to prevent, readily diagnose, and promptly manage the most common manifestations of stroke.
Study Design
Cross-sectional observational study conducted at Stroke Rehabilitation Center, Lahore, Pakistan with the sample size of 120 patients, selected by using convenient sampling.
Results
One hundred and twenty stroke survivors admitted in neurorehabilitation center (Age Mean±SD 56.9±12.2) were classified into 4 groups based on Modified Rankin scale: Mild (17.5%), Moderate (26.6%), Moderate to severe (39.1%), and severe impairment (16.6%). The major modifiable post stroke complications included depression (91%) and anxiety (84%). Acute infections (RTI n=69, 58%, UTI n=78, 65%) and poorly managed chronic disorders such as DM (n=59, 49.1%, 95% CI 0.5-2.5), HTN (n=34, 28%, 95% CI 1.7-2.5), and Kidney failure (n=12, 10%, 95% CI 0.4-3.5) were strongly associated with poor prognosis.
Conclusion
Incidence of stroke was found to be more common in adults (Age: Range=44-69 years, Mean=56.9) with no gender predominance. Most common post stroke complications were depression and anxiety, significantly influencing the recovery process. The severity of the post stroke neurological deficit was positively associated with the frequency of complications and poor neurorehabilitation. Knowledge of post stroke recovery process and effects of various factors on it is essential for the implication of effective clinical and rehabilitation interventions to minimize morbidity and subsequent post stroke disability.
Keywords
brain injury. stroke recovery, neurorehabilitation, disability, stroke management