Disability and residual cognitive impairment from stroke in patients hospitalized in the Internal Medicine Service of the National Medical Center Period 2023-2024
Article Sidebar
Main Article Content
Abstract
Introduction: stroke is one of the leading causes of morbidity, mortality, and disability worldwide. It is characterized by an acute and persistent focal neurological dysfunction resulting from an imbalance between oxygen supply and demand in brain tissue.
Objective: to determine the frequency of cognitive impairment and residual disability in patients hospitalized for stroke in the Department of Internal Medicine at the Centro Médico Nacional – Hospital Nacional, during the period 2023-2024.
Methodology: a descriptive, cross-sectional, observational study was conducted using consecutive case sampling. Patients over 16 years of age with a clinical and/or imaging diagnosis of ischemic or hemorrhagic stroke were included. Those with severe neurological déficits preventing proper application of cognitive test were excluded.
Results: a total of 128 patients were analyzed, of whom 66 (51.6 %) had hemorrhagic stroke. Females represented 52.3 % of the sample, with a mean age of 61.9 ± 14.5 years. The most frequent comorbidities were hypertension (91.6 %), diabetes mellitus (36.7 %), obesity (31.2 %), and tabacco uso disorder (20.3 %). According to the modified Rankin Scale, 28.1 % had very mild disability, 19.5 % moderately severe disability, and 3.9 % were asymptomatic. Based on the Mini-Mental State Examination, 39.8% showed cognitive impairment, 28.9 % suspected impairment, and 16.4 % a high probability of dementia. The mean hospital stay was 24.1 ± 13 days, and 81.2 % of patients were discharged.
Conclusión: a high frequency of cognitive impariment and residual disability was observed among stroke patients, with hemorrhagic stroke being the most prevalent type and hypertension the predominant comorbidity. These findings highlight the importance of incorporationg neurocognitive and functional assessment into routine follow-up and strengthening prevntion and control strategies for cardiovascular risk factors.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Usted es libre de:
- Compartir: copiar y redistribuir el material en cualquier medio o formato para cualquier propósito, incluso comercialmente.
- Adaptar: remezclar, transformar y construir a partir del material para cualquier propósito, incluso comercialmente.
- La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia
Bajo los siguientes términos:
- Atribución: Usted debe dar crédito de manera adecuada, brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
- Compartir igual: — Si remezcla, transforma o crea a partir del material, debe distribuir su contribución bajo la misma licencia del original.
- No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
References
Jadhav AP, Desai SM, Liebeskind DS, Wechsler LR. Neuroimaging of Acute Stroke. Neurol Clin [Internet]. 2020;38(1):185–99. doi: 10.1016/j.ncl.2019.09.004
Farinango C. Factores de riesgo y su influencia en el pronóstico mediante escala de NIHSS y escala de Rankin modificada a corto plazo al ingreso y al egreso hospitalario en pacientes con enfermedad cerebrovascular isquémica ingresados en hospital metropolitano. Ecuador: Pontificia Universidad Católica del Ecuador; 2018. p 1–26.
Murillo-Bonilla LM, Lizola-Hernández J, Lepe-Cameros L, Ruiz-Sandoval JL, Chiquete E, León-Jiménez C, et al. Factores predictivos de discapacidad funcional y muerte a 30 días en sujetos con infarto cerebral agudo: Resultados del Registro Nacional Mexicano de Enfermedad Vascular Cerebral (Estudio RENAMEVASC). Rev Mex Neurocienc. 2011;12(2):68–75. Disponible en: https://previous.revmexneurociencia.com/wp-content/uploads/2014/05/Nm112-01.pdf
Arévalos Guayuan JG, Ayala Servín J, Orué-Vera P, Fariña Garayo ML, Ortiz Espínola MI, Gómez Guerra LS. Factores de riesgo cardiovascular en pacientes con accidente cerebrovascular isquémico agudo en el Hospital Central del Instituto de Previsión Social, Paraguay. Rev. Virtual Soc. Parag. Med. Int. [Internet]. 2020 [citado 2025 Dic 12]; 7(1):50-55. doi:10.18004/rvspmi/2312-3893/2020.07.01.50-055
Bonardo P. Manejo inicial del ataque cerebrovascular agudo. Front en Med [Internet]. 2020;15(2):0116–21. doi: 10.31954/RFEM/202002/0116-0121
Memis D, Kozanoglu E, Kelle B, Goncu MK. Assessment of demographic and clinical characteristics on functional status and disability of patients with stroke. Neurosciences [Internet]. 2016;21(4):352–7. doi: 10.17712/nsj.2016.4.20160212
Farzadfard MT, Sheikh Andalibi MS, Thrift AG, Morovatdar N, Stranges S, Amiri A, et al. Long-term disability after stroke in Iran: evidence from the mashhad stroke incidence study. Int J Stroke [Internet]. 2019;14(1):44–7. doi: 10.1177/174749301878983
Fontclara L, Caballero R, Fretes F, Rolon Acosta PD, Pederzani M, Bianco H, et al. Mortalidad intrahospitalaria de pacientes con COVID-19 complicados con neumonías bacterianas en asistencia respiratoria mecánica en Cuidados Intensivos de Adultos en un Hospital del Paraguay. Rev. Nac. (Itauguá) [Internet]. 2024;16(1):1–15. doi: 10.18004/rdn2024.ene.01.001.015
Broderick JP, Adeoye O, Elm J. Evolution of the modified rankin scale and its use in future stroke trials. Stroke [Internet]. 2017;48(7):2007–12. doi: 10.1161/STROKEAHA.117.017866