Clinical characteristics of in-hospital stroke in general hospitals: analysis of 116 cases

doi:10.11817/j.issn.1673-9248.2020.04.005

Abstract

Abstract:

Objective

To explore the causes and mechanisms of stroke in non-stroke inpatients during hospitalization in general hospitals, and to provide reference information for the development of in-hospital stroke prevention strategies.

Methods

We retrospectively analyzed the clinical data of in-hospital stroke patients who were admitted for other non-stroke diseases in Peking Union Medical College Hospital from January 2009 to September 2012. The characteristics of department distribution, sex, age, stroke type, occurrence and diagnosis time, risk factors, causes and inducements, clinical manifestations, treatment and outcome were analyzed.

Results

There were 116 cases of stroke occurred in hospital, and there were more males than females (1.19:1), with an average age of (56.0±17.7) years. Ischemic stroke was the most common type of stroke (60.34%, 70/116). The in-hospital stroke occurred mainly in Department of Hematology(20, 17.24%), Neurosurgery (15, 12.94%), Emergency Comprehensive Ward (8, 6.90%), Internal Medicine ICU (8, 6.90%), General Internal Medicine (7, 6.04%), Cardiology (7, 6.04%), Respiratory Medicine (6, 5.18%), Immunology (5, 4.31%), Nephrology (5, 4.31%), Urology (5, 4.31%) and ICU (5, 4.31%). 61.21% of the stroke occurred after 7 days of hospitalization, often in resting state, with weakness or numbness of limbs or disturbance of consciousness as the first symptoms. The patients were often complicated with several risk factors of stroke. The common causes of ischemic stroke included heart disease, hypotension, perioperative period, infection, coagulation dysfunction, etc. The common causes of hemorrhagic stroke included coagulation dysfunction, perioperative period, hypertension, hemodialysis, etc. The overall outcome of in-hospital stroke was poor, and the rate of thrombolytic treatment of ischemic stroke was low (2.86%, 2/70).

Conclusion

There are many kinds of risk factors for stroke in general hospitals, which are closely related to patients' comorbidity. Timely and comprehensive assessment of risk factors of cerebrovascular disease, targeted treatment, and avoidance of precipitating factors, are of great importance for stroke prevention in hospitals.

Key words: In-hospital stroke, Risk factors, Atrial fibrillation, Perioperative period, Thrombolysis

Jingwei Zheng, Bin Peng. Clinical characteristics of in-hospital stroke in general hospitals: analysis of 116 cases[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2020, 14(04): 209-216.

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References 27

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年龄分组（岁）	缺血性卒中（例）	出血性卒中（例）	合计[例数（%）]
合计	70	46	116（100）
＜40	10	13	23（19.83）
41~49	5	12	17（14.66）
50~59	12	8	20（17.24）
60~69	14	7	21（18.10）
70~79	24	6	30（25.86）
≥80	5	0	5（4.31）

年龄分组（岁）	缺血性卒中（例）	出血性卒中（例）	合计[例数（%）]
合计	70	46	116（100）
＜40	10	13	23（19.83）
41~49	5	12	17（14.66）
50~59	12	8	20（17.24）
60~69	14	7	21（18.10）
70~79	24	6	30（25.86）
≥80	5	0	5（4.31）

住院科室	缺血性卒中（70例）	出血性卒中（46例）	合计[例数（%）]
血液内科	6	14	20（17.24）
神经外科	11	4	15（12.94）
急诊综合	7	1	8（6.90）
内科重症监护室	4	4	8（6.90）
普通内科	4	3	7（6.04）
心内科（含冠心病重症监护室）	6	1	7（6.04）
呼吸内科	5	1	6（5.18）
免疫内科	1	4	5（4.31）
肾内科	1	4	5（4.31）
泌尿外科	5	0	5（4.31）
重症医学科	2	3	5（4.31）
血管外科	4	0	4（3.45）
基本外科	2	1	3（2.59）
内分泌科	2	0	2（1.72）
肿瘤内科	1	1	2（1.72）
国际医疗部	1	1	2（1.72）
骨科	1	1	2（1.72）
感染内科	1	1	2（1.72）
消化内科	1	1	2（1.72）
加强医疗科	1	1	2（1.72）
眼科	2	0	2（1.72）
皮肤科	1	0	1（0.86）
胸外科	1	0	1（0.86）

住院科室	缺血性卒中（70例）	出血性卒中（46例）	合计[例数（%）]
血液内科	6	14	20（17.24）
神经外科	11	4	15（12.94）
急诊综合	7	1	8（6.90）
内科重症监护室	4	4	8（6.90）
普通内科	4	3	7（6.04）
心内科（含冠心病重症监护室）	6	1	7（6.04）
呼吸内科	5	1	6（5.18）
免疫内科	1	4	5（4.31）
肾内科	1	4	5（4.31）
泌尿外科	5	0	5（4.31）
重症医学科	2	3	5（4.31）
血管外科	4	0	4（3.45）
基本外科	2	1	3（2.59）
内分泌科	2	0	2（1.72）
肿瘤内科	1	1	2（1.72）
国际医疗部	1	1	2（1.72）
骨科	1	1	2（1.72）
感染内科	1	1	2（1.72）
消化内科	1	1	2（1.72）
加强医疗科	1	1	2（1.72）
眼科	2	0	2（1.72）
皮肤科	1	0	1（0.86）
胸外科	1	0	1（0.86）

危险因素	缺血性卒中（70例）	出血性卒中（46例）
高血压病	39（55.71）	12（26.09）
2型糖尿病	22（31.43）	6（13.04）
高脂血症	7（10.00）	3（6.52）
心脏病（心房颤动、冠心病等）	25（35.71）	3（6.52）
既往卒中史	14（20.00）	6（13.04）
吸烟史^a	25（35.71）	13（28.26）
饮酒史^a	9（12.86）	7（15.22）
睡眠呼吸暂停综合征	2（2.86）	0

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