The Relationship Between Blood Pressure At The Beginning Of Entering With The Severity Of Ischemic Stroke Based On Nihss In Inpatients At H. Adam Malik Hospital Medan In 2022

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The Relationship Between Blood Pressure at the Beginning of Entering with the Severity of Ischemic Stroke Based on NIHSS in Inpatients at H. Adam Malik Hospital Medan in 2022

Introduction

Ischemic stroke is a neurological disorder that affects millions of people worldwide, causing significant morbidity and mortality. One of the main risk factors that contribute to the severity of stroke is high blood pressure. Understanding the relationship between blood pressure when patients are hospitalized and the severity of ischemic stroke is crucial in developing effective treatment strategies. This study aims to analyze the relationship between blood pressure at the beginning of hospitalization with the severity of ischemic stroke based on the National Institute of Health Stroke Scale (NIHSS) in inpatients at H. Adam Malik Hospital Medan in 2022.

Background

Ischemic stroke is a complex condition characterized by a deficit due to blockage of blood vessels in the brain. High blood pressure is one of the main risk factors that affect the severity of stroke. The NIHSS scale is a widely used tool to assess the degree of stroke severity, with higher scores indicating more severe strokes. Understanding the relationship between blood pressure and stroke severity is essential in developing effective treatment strategies.

Research Purposes

This study aims to analyze the relationship between blood pressure at the beginning of hospitalization with the severity of ischemic stroke based on NIHSS in inpatients at H. Adam Malik Hospital Medan in 2022. The study aims to investigate the following research questions:

  • Is there a significant relationship between blood pressure at the beginning of hospitalization and the severity of ischemic stroke based on NIHSS?
  • What is the relationship between blood pressure and stroke severity in patients with ischemic stroke?

Research Methods

This research is an observational analytic study with a cross-sectional design. The sample of this study was taken from ischemic stroke patients treated at H. Adam Malik Hospital Medan in 2022 using the purposive sampling method. The number of samples needed was determined using the Slovin formula, with a total of 120 patients. The data used in this study was taken from the patient's medical record. The analysis used was univariate and bivariate analysis with chi-square tests.

Research Result

The study included a total of 120 patients, with 64 patients (53.3%) being male and 83 patients (69.2%) aged over 55 years. As many as 79 patients (65.8%) did not have a history of diabetes mellitus (DM), while 76 patients (63.3%) had a moderate stroke. Interestingly, of the 120 patients, as many as 30 patients (25%) recorded grade 1 hypertension. Statistical analysis shows a significant relationship between blood pressure when entering with the severity of the ischemic stroke according to NIHSS, with the following results:

  • Hypertension stage 1 (p = 0.005; OR = 4.38)
  • Hypertension stage 2 (p <0.001; OR = 8.76)
  • Hypertension stage 3 (p <0.001; OR = 19.71)

Conclusion

Based on the results of the study, it was found that there was a significant relationship between blood pressure at the beginning of hospitalization with the severity of ischemic stroke based on NIHSS. This discovery shows the importance of managing blood pressure in an effort to prevent or reduce the severity of ischemic stroke in patients. Therefore, the precaution and treatment of hypertension must be the main focus in patient health management to reduce the risk of stroke and improve the quality of life of patients who experience neurological disorders.

Implications

By understanding the relationship between blood pressure and the severity of stroke, it is expected to help medical personnel in making better clinical decisions in the care of stroke patients. This study highlights the importance of managing blood pressure in patients with ischemic stroke, and the need for further research in this area.

Limitations

This study has several limitations, including the small sample size and the use of a single hospital as the study site. Future studies should aim to include a larger sample size and multiple hospitals to increase the generalizability of the findings.

Future Directions

Future studies should aim to investigate the relationship between blood pressure and stroke severity in patients with ischemic stroke, and to develop effective treatment strategies to manage blood pressure in these patients. Additionally, further research is needed to understand the underlying mechanisms of the relationship between blood pressure and stroke severity.

Recommendations

Based on the findings of this study, the following recommendations are made:

  • Healthcare providers should prioritize the management of blood pressure in patients with ischemic stroke.
  • Further research is needed to understand the relationship between blood pressure and stroke severity.
  • Effective treatment strategies should be developed to manage blood pressure in patients with ischemic stroke.

Conclusion

In conclusion, this study found a significant relationship between blood pressure at the beginning of hospitalization with the severity of ischemic stroke based on NIHSS in inpatients at H. Adam Malik Hospital Medan in 2022. This discovery highlights the importance of managing blood pressure in an effort to prevent or reduce the severity of ischemic stroke in patients. Therefore, the precaution and treatment of hypertension must be the main focus in patient health management to reduce the risk of stroke and improve the quality of life of patients who experience neurological disorders.
Q&A: The Relationship Between Blood Pressure and Ischemic Stroke

Q: What is the relationship between blood pressure and ischemic stroke?

A: Ischemic stroke is a neurological disorder that occurs when a blood vessel in the brain is blocked, leading to a lack of blood flow to the brain. High blood pressure is a major risk factor for ischemic stroke, as it can cause damage to blood vessels and increase the risk of blockage.

Q: How does blood pressure affect the severity of ischemic stroke?

A: Research has shown that high blood pressure at the time of hospital admission is associated with more severe ischemic stroke. This is because high blood pressure can cause damage to blood vessels and increase the risk of blockage, leading to more severe symptoms.

Q: What are the different stages of hypertension and how do they relate to ischemic stroke?

A: Hypertension is typically classified into three stages:

  • Stage 1: Blood pressure is elevated, but not high enough to cause damage to blood vessels.
  • Stage 2: Blood pressure is high enough to cause damage to blood vessels and increase the risk of blockage.
  • Stage 3: Blood pressure is extremely high and can cause severe damage to blood vessels and increase the risk of blockage.

Research has shown that each stage of hypertension is associated with an increased risk of ischemic stroke, with Stage 3 being the most severe.

Q: What are the symptoms of ischemic stroke?

A: The symptoms of ischemic stroke can vary depending on the location and severity of the blockage. Common symptoms include:

  • Sudden weakness or numbness in the face, arm, or leg
  • Sudden confusion or trouble speaking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, or loss of balance
  • Sudden severe headache with no known cause

Q: How is ischemic stroke diagnosed?

A: Ischemic stroke is typically diagnosed using a combination of medical history, physical examination, and imaging tests, such as:

  • Computed Tomography (CT) scan
  • Magnetic Resonance Imaging (MRI) scan
  • Angiogram
  • Electroencephalogram (EEG)

Q: What is the treatment for ischemic stroke?

A: The treatment for ischemic stroke depends on the severity and location of the blockage. Common treatments include:

  • Medications to reduce blood pressure and prevent further blockage
  • Thrombolytic therapy to dissolve the blood clot
  • Surgery to remove the blood clot
  • Rehabilitation to help patients recover from the stroke

Q: Can ischemic stroke be prevented?

A: Yes, ischemic stroke can be prevented by managing risk factors, such as:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking
  • Obesity
  • Family history of stroke

Q: What is the prognosis for patients with ischemic stroke?

A: The prognosis for patients with ischemic stroke depends on the severity and location of the blockage. With prompt treatment, many patients can recover fully, while others may experience long-term disability.

Q: What is the role of healthcare providers in managing ischemic stroke?

A: Healthcare providers play a critical role in managing ischemic stroke by:

  • Diagnosing and treating the condition
  • Managing risk factors
  • Providing rehabilitation and support to patients and their families
  • Educating patients and their families about the condition and its treatment

Q: What is the importance of blood pressure management in ischemic stroke?

A: Blood pressure management is critical in ischemic stroke because high blood pressure can cause damage to blood vessels and increase the risk of blockage. Managing blood pressure can help prevent or reduce the severity of ischemic stroke.