Ischemic Stroke; A Severe Complication In Patients Admitted To Resuscitation

Abstract

Stroke is a real public health problem because of its incidence and morbimortality. Ischemic stroke (AVCI) accounts for 80% of strokes. It is the third leading cause of overall mortality in industrialized countries, after heart disease and cancer, and the leading cause of physical disability acquired. The objective of our study was to describe the clinical characteristics, and factors of Cardiovascular Risk (LRIF) and the factors associated with death in patients admitted for stroke (AVCI) and them in a resuscitation ward. Methods: Retrospective study over a 12-month period (between January 1, 2018 and January 1, 2019), conducted in the medical-surgical emergency room. Results: A total of 147 strokes: 110 AVCI (84%). The age of the patients included in the study ranged from 49 to 77 years. The average age was 66 years - 10.9 years, 75% of AVCI occurring after 65 years. Sex divided into 47 women (42.72%). And 63 men (57.28%). Ischemic strokes: The main vascular risk factors three risk factors: severe high blood pressure (0.007), diabetes (0.05) and emboligenic heart disease (0.017). Other risk factors found are tobacco (13.09%), obesity (10.7%), dyslipidemia (08.3%), alcohol (7.1%). 17, 8% of patients had a history of formed stroke or TIA (Table 1). The onset of neurological symptomatology was brutal in 70% (77 patients). The clinical examination at admission found consciousness disorders with a NIHSS score of 5 to 15 in 45.54% of cases (49 patients). 23 patients (20.9%) had a NIHSS score of 15 and 39 patients (35.45). Para clinical cardiac evaluation (ECG, Echocoeur) objective a complete arrhythmia by atrial fibrillation (AC/FA) in 11.4% of cases, left atrial hypertrophy in 40% of cases and left ventricular hypertrophy in 89% of cases. The length of hospitalization in resuscitation ranged from 1 to 46 days with an average of 13.4 days (-10.1). Among the 110 patients 22 died or (20%). Three risk factors associated with the poor prognosis: NIHSS SUP(p - 0.0001), anisocoria(p - 0.006) and long stay in reanimation(p - 0.013). Conclusion: Ischemic strokes have a major public health impact in terms of mortality or morbidity because of the physical and psychological consequences they can cause. The management of cardiovascular risk factors, the first of which is the HTA, keeps its interest with the peculiarity of diabetic balance and the cessation of tobacco in combination with a diet. Cardiovascular assessment (ACFA, HAG, HVG) plays an important role in stroke management. Primary and secondary stroke prevention requires the prevention of thromboembolic accidents (ACFA) Stroke remains a challenge.