A Comparative Study on the Effectiveness of Care and Treatment for Patients with Intracerebral Hemorrhage Before and After the Establishment of the Hemorrhagic Stroke Unit at Roi Et Hospital
Keywords:
hemorrhagic stroke patients, care and treatment, hemorrhagic stroke unitAbstract
Background and Objectives: Intracerebral hemorrhage is a medical emergency with high mortality and disability rates. This study aimed to compare treatment outcomes and risk factors for mortality in stroke patients before and after the establishment Hemorrhagic Stroke Unit at Roi Et Hospital.
Methods: This study was a retrospective cohort study that collected treatment data from medical records of stroke patients who underwent surgery at Roi Et Hospital. The study was divided into two periods: before the establishment of the specialized stroke unit (January 1, 2018 – March 31, 2021, 292 cases) and after its establishment (April 1, 2021 – September 8, 2023, 252 cases). Data analysis used descriptive statistics, independent t-test, Chi-square test, univariate, and multivariate logistic regression, with a significance level set at p < 0.05.
Results: Stroke patients who underwent surgery in both groups showed statistically significant differences in hypertension (p=0.039) and having undergone more than two times (p<0.001). A comparison of treatment outcomes before and after the establishment of the stroke unit revealed no statistically significant differences in mortality rate (p=0.739) or functional recovery, defined as the ability to perform self-care (p=0.866). However, the length of hospital stay was significantly reduced, with the median duration decreasing from 24 days before the unit was established to 18 days (p=0.013). Risk factors associated with overall mortality included chronic kidney disease (p=0.031), an ICH score greater than 3 (p<0.001), and having undergone more than two surgeries (p=0.025). Tracheostomy (p<0.001) was a significant factor in reducing mortality risk. Three-month quality of life assessments showed that before the stroke unit was established, 33.22% of patients had recovered to a level where they could care for themselves, while 32.54% of patients achieved the same recovery level after the unit was established. Comparison of treatment outcomes between the two groups revealed no significant differences in mortality (p=0.739) or self-care recovery (p=0.866), but the length of hospital stay differed significantly (p=0.001). After the establishment of the stroke unit, the mortality rate in patients who waited more than 120 minutes for surgery increased, and the overall rate of recovery to self-care ability slightly declined compared to the pre-stroke unit period.
Conclusions: The establishment of the hemorrhagic stroke unit at Roi Et Hospital significantly reduced patients’ length of hospital stay. However, no significant differences were found in mortality rates or quality of life at 3 months between the periods before and after the unit's establishment. Additionally, early tracheostomy was associated with a reduced risk of mortality, highlighting a potential area for further investigation in future studies.
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