Authors (including presenting author) :
Mok YNM(1), Chan YS(1), Chui KS(1), Ho PC(1), Duong KH(1), Cheng S(1), Li R(1), AuYeung M(1), Cheung CM(1)
Affiliation :
(1) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Stroke is an extremely serious occurrence which requires emergency medical attention. If not, it may result in disability, dependence or even death. Stroke can occur as a result of numerous risk factors. Therefore, besides faster treatment and rehabilitation, completion of Stroke Risk Factor Screening (SRFS) after admission is important to identify common preventable risk factors, such as hypertension, hyperlipidaemia, diabetes, atrial fibrillation (AF), Carotid Artery stenosis (CAS). Thereafter, consistent post-stroke treatment care, strictly medical follow-up with prescribed medication and life-style modification are crucial to prevent another stroke. From 2003 onwards, Stroke Nurses (SN) coordinated the completion of SRSP under Neurology Team support.
Objectives :
To evaluate the effectiveness of standardized SRFS coordinated by SN for hospitalized acute stroke patients.
Methodology :
Trained SN coordinated all hospitalized acute stroke patients to complete SRFS such as blood pressure (BP), fasting blood checking for sugar and lipid levels, electrocardiogram, extracranial vessel examinations either by Carotid Duplex ultrasound examination or Computed-Tomography Angiogram or Magnetic-Resonance Angiogram. We conducted a retrospective review on recent 5-year (2019 to 2023) acute stroke admissions from our department stroke database. All data was collected prospectively and entered in “Microsoft Excel” for analysis.
Result & Outcome :
Compared year 2019 to 2023, yearly acute stroke admissions were 923 to 1035 with average age increased from 73.4 to 75.2. All patients had BP monitoring and completed blood checking as requested in SRSP. Increasing trend in risk factors of hypertension, hyperlipidaemia, diabetes and AF of yearly stroke admissions were 72.1% to 76.3%, 69.3% to 81.2%, 30.1% to 33.0%, 25.4% to 29.2% respectively. After admission, newly diagnosed hypertension, diabetes, hyperlipidaemia were 7.75%, 3.67%, 25.59% (average age 63.5 to 69.0) and AF was 9.66% (average age 80.4) of all acute strokes. Completion of extracranial vessel examinations for hospitalized acute ischaemic stroke to rule out CAS were increased from 52.2% to 82.4%. Patients found with >50% CAS for further intervention were increased from 3.3% to 6.5% of yearly stroke admissions. In conclusion, by increasing trend of stroke risk factors, SN coordination on completion of standardized SRFS can effectively identify newly diagnosed risk factors and blood vessels abnormalities to receive timely treatment for secondary stroke prevention.
