Factors Influencing Activities of Daily Living in Patients with Acute Ischemic Stroke: A Retrospective Study
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Abstract
This research was a retrospective study to determine the predictive relationship of factors for recurrent stroke. The factors were aphasia, neglect, initial blood glucose, Body Mass Index (BMI), and nutritional status on Activities of Daily Living in acute ischemic stroke patients. The subjects were 310 acute ischemic stroke patients, both males and females, aged 18 years and older, admitted to the acute stroke unit. The researcher collected personal information, laboratory results and treatment, the Thai version of the National Institute of Health Stroke Scale for assessing stroke severity, and the total Barthel's Index (BI) score for assessing Activities of Daily Living from the patient's medical records. The researcher analyzed the data using descriptive statistics, Spearman rank correlation coefficient, and logistic regression analysis.
The results showed that 61.9% of the patients had impaired ability to perform daily activities, with a mean BI score of 50.7 (SD = 35.6) on the first day of admission, and 26.8% of them, with a mean BI score of 80 (SD = 27) on the discharge day. Factors that were statistically significant for predicting impaired ability to perform daily activities in acute ischemic stroke patients (p < .05) were aphasia (OR = 1.88, 95% CI = 1.06 - 3.33, p = .031), neglect (OR = 3.97, 95% CI = 1.69 - 9.29, p = .002), BMI (OR = 1.06, 95% CI = 1.01 -1.12, p = .045) and nutritional status (OR = .48, 95% CI = .26 - .88, p = .019). The analysis revealed that the prediction was 73.9% correct. On the other hand, the recurrent stroke and initial blood glucose did not correlate to predict the patient's Activities of Daily Living.
Based on the study results, the healthcare team should screen aphasia, neglect, BMI, and nutritional status in all acute ischemic stroke patients on admission and help them improve their conditions at the beginning of the disease to reduce the impaired ability to perform daily activities. Moreover, the healthcare team should prepare the caregivers to cooperate with these conditions before discharge, which would be able to reduce impairments of ADL at home.
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