Cerebrovascular Stroke Recurrence among Critically Ill Patients at a Selected University Hospital in Egypt

Abstract

Cerebrovascular stroke (CVS) is a fatal disease. Literature review cited that, CVS recurrence is more devastating than the first attack. The risk of recurrent CVS is up to 15 times greater than the risk of CVS and is attributed to insufficient control of risk factors and non compliance with medical advice. So that, identification of risk factors of recurrence is an important role of the critical care nurses, plays an essential role in the prevention of further stroke. Aim: to study the risk factors, frequency and severity of recurrent cerebrovascular stroke among adult critically ill patients admitted to intensive care units. Research questions: Q1- What are the risk factors of recurrent cerebrovascular stroke among critically ill patients at a selected university hospital? Q2- What are the intervals of recurrence from the first attack of cerebrovascular stroke? Q3- What is the frequency of recurrent cerebrovascular stroke attacks among critically ill patients?  Q4-What is the severity rate of recurrent cerebrovascular stroke among critically ill patients?. A descriptive exploratory research design was utilized in the current study. The study was conducted at different CVS intensive care units at a selected University Hospital. A sample of convenience including all adult patients admitted to the ICU with recurrent CVS over a period of six months (80 patients) was included. Three tools were used for data collection: socio-demographic and medical data sheet, CVS risks factors assessment sheet, and the National Institutes of Health Stroke Scale (NIHSS). Results: The majority of the studied group admitted with the first recurrence of CVS, had different chronic illnesses such as hypertension (100%) & diabetes mellitus (95%). The duration of CVS recurrence ranged from two - < five years among 30% of the studied group. 36.25% of the studied group admitted with severe degree of CVS with a mean severity score of (X = 19.17 + SD = 1.255). Conclusions: uncontrollable risk factors (old age, male gender, marriage); life style risk factors (smoking, obesity, low income); chronic medical diseases (old CVS, hypertension, diabetes mellitus, ischemic heart disease,  myocardial infarction, heart failure,… etc ); noncompliance with prescribed drugs of chronic illnesses, abnormal laboratory investigations (high cholesterol, triglyceride, low density lipoprotein) represented the common risk factors and contributed to recurrent cerebrovascular stroke with different severity.

Key words: Cerebrovascular stroke, recurrence, critically ill patients, risk factors, severity.