The Modified Rankin Scale, The Barthel’s ADL Index, The National Institute of Health Stroke Scale, and Death Rate of Acute Stroke Patients Receiving Thrombolytic Agent Therapy and Not Receiving Thrombolytic Agent Therapy in Rayong Hospital

Abstract

This descriptive research aimed to study the Modified Rankin Scale (morbidity level), the Barthel’s ADL index (ADL capacity), the National Institute of Health Stroke Scale (severity level), and mortality rate of acute stroke patients receiving and not receiving thrombolytic agent therapy. The samples were 1,728 medical records of acute ischemic stroke patients who received services at Rayong Hospital, fiscal year 2018 and 2019. The research instruments were composed of the general data record form, the Modified Rankin Scale, the Barthel’s ADL index, and the National Institute of Health Stroke Scale. Data were collected from September to December, 2020. Statistics used for data analysis included frequency, percentage, mean, standard deviation, Wilcoxon signed-rank test, Mann-Whitney U test, and Chi-square test.

The research results revealed that 1) on the day of discharge, the patients receiving and not receiving thrombolytic agent therapy had statistically significant lower mean scores of morbidity level and severity level, and higher mean score of ADL capacity than those on the day of admission (p < .001); 2) on the day of admission, the patients receiving thrombolytic agent therapy had statistically significant higher mean scores of morbidity level and severity level, and lower mean score of ADL capacity than those of the patients not receiving thrombolytic agent therapy (p < .001). In addition, on the day of discharge (fiscal year 2019), the patients receiving thrombolytic agent therapy had statistically significant lower mean score of severity level than that of the patients not receiving thrombolytic agent therapy (p < .05); and 3) the mortality rate of the patients receiving and not receiving thrombolytic agent therapy were not different.

This research suggests that healthcare executives should promote setting stroke unit in the hospitals as well as develop a standard of care for stroke patients who cannot receive thrombolytic agent therapy in time.