Asep Nugraha Hermawan
Department of Neurology, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

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CLINICAL OUTCOME OF STROKE PATIENTS BASED ON THE NATIONAL INSTITUTES OF HEALTH STROKE SCALE (NIHSS) IN A TERTIARY HOSPITAL Liunardo Bintang Pratama; Lisda Amalia; Cep Juli; Uni Gamayani; Asep Nugraha Hermawan
MNJ (Malang Neurology Journal) Vol. 9 No. 1 (2023): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2023.009.01.4

Abstract

Background: Stroke is the second leading cause of death and the third cause of disability globally. Clinical outcomes caused by stroke are varied and influenced by various factors. Objective: This study aims to describe the clinical outcome of stroke patients based on neurological deficit using NIHSS at Dr. Hasan Sadikin General Hospital, Bandung. Methods: This study is a retrospective descriptive, cross-sectional study using secondary data from medical records recruited between January 2019 – December 2019 at the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung with the total sampling method. Variables include demographic data, risk factors, and clinical characteristics. Neurological deficit was assessed using NIHSS. Data were analyzed and presented in the form of tables. Results: There were 202 subjects eligible for this study, including ischemic (71.8%) and intracerebral hemorrhage (28.2%) stroke patients. Most of the subjects were male (53%), aged ≥60 years (50,5%), presenting with onset >6 hours (72.3%), and had hypertension (92,1%). Most of the subjects have a moderate stroke (n=102;50.5%) based on the NIHSS score at admission and mild stroke (n=117;57.9%) based on the NIHSS score at discharge, with a motor deficit as the most common neurological deficit found. Conclusion: The majority of stroke patients presented with a moderate stroke on admission and had a clinical improvement during hospital treatment, with most of the patients experiencing a mild stroke on discharge based on NIHSS score. The motor deficit is the most common neurological deficit that affects clinical outcomes.
COMPARISON OF COGNITIVE FUNCTION BETWEEN FIRST ISCHEMIC STROKE AND RECURRENT ISCHEMIC STROKE PATIENTS Fildza Intan Rizkia; Chandra Calista; Suryani Gunadharma; Asep Nugraha Hermawan; Lisda Amalia; Paulus Anam Ong
MNJ (Malang Neurology Journal) Vol. 8 No. 1 (2022): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2022.008.01.7

Abstract

Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment.Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung.Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analyzed using the Mann-Whitney U test.Results: There were 428 subjects eligible for this study, with 207 subjects categorized as first ischemic stroke group and 221 subjects categorized as recurrent ischemic stroke group. There was a statistically significant difference in MMSE scores between the first ischemic stroke patients (24.90 ± 4.64) and recurrent ischemic stroke patients (22.85 ± 4.64 ) with a p value of 0.002.Conclusion: Recurrent ischemic stroke patients had lower MMSE scores than the first ischemic stroke patients. Clinicians should be more aware in detecting early cognitive impairment in stroke patients and in preventing the incidence of recurrent stroke.