Characteristics of Inpatient Care and Rehabilitation for Acute First-Ever Stroke Patients

PURPOSE: The purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients. MATERIALS AND METHODS: This study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge. RESULTS: A total of 2159 patients were reviewed. The mean age was 61.5+/-14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management. CONCLUSION: Our analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke.

Trends in the Incidence of Hospitalized Acute Myocardial Infarction and Stroke in Korea, 2006-2010

This study attempted to calculate and investigate the incidence of hospitalized acute myocardial infarction (AMI) and stroke in Korea. Using the National Health Insurance claim data, we investigated patients whose main diagnostic codes included AMI or stroke during 2006 to 2010. As a result, we found out that the number of AMI hospitalized patients had decreased since 2006 and amounted to 15,893 in 2010; and that the number of those with stroke had decreased since 2006 and amounted to 73,501 in 2010. The age-standardized incidence rate of hospitalized AMI, after adjustment for readmission, was 41.6 cases per 100,000-population in 2006, and had decreased to 29.4 cases in 2010 (for trend P < 0.001). In the case of stroke was estimated at 172.8 cases per 100,000-population in 2006, and had decreased to 135.1 cases in 2010 (for trend P < 0.001). In conclusion, the age-standardized incidence rates of both hospitalized AMI and stroke in Korea had decreased continuously during 2006 to 2010. We consider this decreasing trend due to the active use of pharmaceuticals, early vascular intervention, and the national cardio-cerebrovascular disease care project as the primary and secondary prevention efforts.

Awareness of Stroke Warning Signs and Risk Factors: Result of a 2010 Community Survey in Gwangju Metropolitan City

BACKGROUND: A high level of public awareness of stroke may reduce the stroke risk. The aim of this study was to assess the public's awareness of stroke warning signs and risk factors, and to determine the associated factors. METHODS: The study population was 2492 community-dwelling adults aged 50 years and older who participated in the 2010 baseline Dong-gu Study. Information regarding knowledge of stroke warning signs, stroke risk factors, and demographics was collected using standardized open- and closed-form questionnaires. RESULTS: The stroke warning signs that were most frequently identified by respondents were "sudden numbness or weakness" (73.7%) and "sudden difficulty in speaking or in understanding speech" (73.6%). In multivariate analysis, incomplete awareness of stroke warning signs was significantly associated with a lower education level, no history of past stroke, and incorrect knowledge of the definition of stroke. Hypertension and stress were most commonly recognized as risk factors when open-ended questions were used (by 22.3% and 14.1% of the respondents, respectively) and also with close-ended questions (77.7% and 82.4%, respectively). In multivariate analysis, older age, current smoking, lower education level, and incorrect knowledge of the definition of stroke were associated with a worse awareness of stroke risk factors. CONCLUSIONS: A community-based program is needed to improve public awareness of the warning signs and risk factors for stroke. In order to reduce the risk of stroke, public health education and media efforts should focus on people who are older and have a lower level of education.