بررسي عوامل موثر بر طول مدت بستري بيماران مبتلا به سكته مغزي ايسكميك تحت درمان با ترومبوليز داخل وريدي

Factors Affecting the Length of Hospital Stay in Patients with Ischemic Stroke Treated by Intravenous Thrombolysis

استروك يا سكته مغزي ايسكميك يكي از شايع ترين بيماري هاي نورولوژيك است كه در بسياري از موارد منجر به ناتواني بيماران مي شود. اين مطالعه با هدف بررسي فاكتورهاي موثر بر طول مدت بستري در بيماران مبتلا به استروك ايسكميك تحت درمان ترومبوليتيك طراحي شد. مواد و روش ها: اين مطالعه توصيفي-تحليلي به صورت گذشته نگر بر روي پرونده هاي بيماران بزرگسال پي درپي مراجعه كننده با تشخيص استروك ايسكميك كه درسال هاي97-1395 در بخش مغز و اعصاب بيمارستان بوعلي سينا ساري تحت درمان ترومبوليتيك با آلتپلاز قرار گرفته اند، طراحي شد. فاكتورهاي مرتبط با طول مدت بستري مورد بررسي قرارگرفت. يافته ها: ﭘﺮوﻧﺪه 173 ﺑﯿﻤﺎر ﺑﺮرﺳﯽ ﺷﺪﻧﺪ ﮐﻪ 95 ﺑﯿﻤﺎر )54/9 درﺻﺪ( آنﻫﺎ ﻣﺮد ﺑﻮدﻧﺪ. ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ ﺑﯿﻤﺎران 68/5±12/3 ﺳﺎل ﺑﻮد. در ﺳﯿﺮ ﺑﺴـﺘﺮي 19/7 درﺻـﺪ ﺑﯿﻤـﺎران دﭼـﺎر ﭘﻨﻮﻣـﻮﻧﯽ، 9/8 درﺻـﺪ دﭼـﺎر ﻋﻔﻮﻧـﺖ ادراري و 2/1 درﺻـﺪ ﺑـﻪ ﺳـﺎﯾﺮ ﻋﻔﻮﻧﺖﻫﺎ دﭼﺎر ﺷﺪه ﺑﻮدﻧﺪ. ﻋﻮارض ﻫﻤﻮراژﯾﮏ ﻧﺎﺷﯽ از آﻟﺘﭙﻼز در 12/7 درﺻﺪ ﺑﯿﻤﺎران ﻣﺸﺎﻫﺪه ﺷﺪ. 52/6 درﺻـﺪ ﺑﯿﻤـﺎران ﮐﻢﺗﺮ از 7 روز و 4/47 درﺻﺪ ﺑﻪ ﻣﺪت 7 روز و ﺑﯿﺶﺗـﺮ در ﺑﯿﻤﺎرﺳـﺘﺎن ﺑﺴـﺘﺮي ﺑﻮدﻧـﺪ. ﻃـﻮل ﻣـﺪت ﺑﺴـﺘﺮي در ﺑﯿﻤﺎرﺳـﺘﺎن ﺑـﺎ ﻫﺎﯾﭙﺮﻟﯿﭙﯿـﺪﻣﯽ )0/005=P(، ﺷــﺪت ﺳــﮑﺘﻪ ﻣﻐــﺰي )0/02=P(، درﮔﯿــﺮي ﻋــﺮوق ﺑــﺰرگ )0/001

Ischemic stroke is one of the most common neurological diseases that leads to disability in many cases. The aim of this study was to investigate the factors affecting the duration of hospitalization in patients with ischemic stroke undergoing thrombolytic therapy. Materials and methods: This retrospective descriptive-analytical study was performed in consecutive adult patients with ischemic stroke who underwent thrombolytic treatment in Neurology Department of Sari Bu Ali Sina Hospital 2016-2018. Factors associated with duration of hospitalization were investigated. Results: The records of 173 patients (54.9% males) were studied and the mean age of patients was 68.5 ± 12.3 years. During hospitalization, pneumonia, urinary tract infection, and other infections were seen in 19.7%, 9.8%, and 1.2%, respectively. Among the patients, 12.7% experienced hemorrhagic complications. Duration of hospitalization was <7 days in 52.6% and ≥7 days in 47.4% of the patients. Length of hospitalization was significantly associated with hyperlipidemia (P=0.005), stroke severity (P=0.02), large vessel stroke (P<0.001), hemorrhagic complications (P=0.004), and nosocomial infections (P<0.001). Conclusion: Hyperlipidemia, stroke severity, complications of thrombolysis, and nosocomial infections affect the length of hospital stay in patients with ischemic stroke who received alteplase. Therefore, appropriate approach is needed in management of these patients to prevent and eliminate the aforementioned factors.