• The Journal of Korean Medicine
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• v.24 no.1
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• pp.181-189
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• 2003

Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.

• Journal of muscle and joint health
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• v.19 no.2
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• pp.107-119
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• 2012

Purpose: This study was conducted to extract international classification of functioning, disability, and health (ICF) core sets for measuring functional status in acute stroke patients, and to evaluate clinical applicability of the core sets. Methods: A set of 22 ICF items on functional status in acute stroke patients were extracted from the Korean general ICF core sets and ICF core sets for stroke patients. The extracted ICF functional items were assessed at the time of admission and discharge among 100 stroke patients who were admitted in a university hospital. Results: Comparing to functional status at admission of acute stroke patients, the overall functional status at discharge was improved. However, functions on defecation, skin protection, and relationship with immediate family at the time of discharge were not significantly changed. Conclusion: The set of ICF functional items identified in this study may be reliable and valid to assess acute stoke patients' body functions, activities and participation and environmental factors in the holistic and comprehensive nursing context. Nursing interventions on bowel elimination and skin protection for acute stroke patients need to be developed.

• Korean Journal of Clinical Pharmacy
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• v.34 no.2
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• pp.79-99
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• 2024

Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• Journal of Digital Convergence
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• v.11 no.6
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• pp.221-233
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• 2013

This study aims to develop the severity-adjusted length of stay(LOS) model for acute stroke patients using data from the hospital discharge survey and propose management of length of stay(LOS) for acute stroke patients and using for Hospital management. The dataset was taken from 23,134 database of the hospital discharge survey from 2004 to 2009. The severity-adjusted LOS model for the acute stroke patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of acute stroke patients were acute stroke type. The difference between severity-adjusted LOS from the decision making tree model and real LOS was compared and it was confirmed that insurance type and bed number of hospital, location of hospital were statistically associated with LOS. And to conclude, hospitals should manage the LOS of acute stroke patients applying it into the medical information system.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.806-812
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• 2009

Objective : The aim of this study was to provide basic background information on stroke by evaluation various etiological factors on the basis that the Tongue fur color of acute stroke patients. Method : We studied patients hospitalized within 4 weeks after their ictus who were admitted at Kyunghee University Oriental Medical Center, Dongguk University Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center, and Kyungwon University Incheon Oriental Medical Center from April 2008 to August 2009. We compared the general characteristics of acute stroke patients according to tongue fur color. Result : Tongue fur color showed significant difference for past history of hypertension, hyperlipidemia, stroke, HDL-chol, BUN, Hg, and pulse pattern. Conclusion : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their tongue fur color. Further studies will be needed to better understand the difference between yellow fur group and white fur among acute stroke patients.

• Journal of the Korea Society of Computer and Information
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• v.21 no.7
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• pp.53-59
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• 2016

The purpose of this study was to investigate the factors of hospital arrival delays of acute ischemic stroke patients. The study subjects were 126 cerebral infarction patients G Metropolitan City university hospital emergency center. General characteristics, disease-related characteristics and stroke-related were collected by self-reported questionnaires. Hospital arrival times by subjects' characteristics were tested by $x^2$ test and logistic regression analysis. Of 126 cerebral infarction patients, Their average hours taken to move to a hospital was 12.7 hours with the fastest case being 0.5 hour and the most delayed case being 127.8 hours. 61.1%(77 persons) of the stroke patients under this experiment said to have taken 3 hours or less. In logistic regression analyses, Coming to the hospital directly without passing through other hospitals was found to have higher probability of arriving less than 3 hours(${\beta}$=2.960, p=.009), And if LAPSS was tested positive, such cases are more likely to arrive within 3 hours(${\beta}$=2.219, p=.049). For acute ischemic stroke and caregivers need training to be conducted promptly admitted to hospitals for education and treatment hospital stroke screening will help to improve the treatment of stroke patients

• The Journal of Internal Korean Medicine
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• v.21 no.3
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• pp.369-376
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• 2000

Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.905-914
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• 2006

Background and Purpose : The purpose of this study was to classify according to the TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) acute stroke patients (first-ever stroke) treated at the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital. Methods : In the time period Oct. 2005 to Oct. 2006. 101 patients with a first-ever stroke admitted to the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. They had neurological deficits for a time more than 24 hours. We classified patients according to the original TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) Results : The incidence in males was 54.4%, in females was 45.6%. Ischemic stroke (86.l%) was more common than hemorrhagic stroke (13.9%). The results of TOAST classification in this study were as follows: small-vessel occlusion, 72.4% large-artery atherosclerosis. 14.9 % cardioembolism, 4.6% stroke of other determined etiology, 4.6%: stroke of undetermined etiology, 3.5%. Patients in the small-vessel occlusion subgroup in this study were the most frequent. The result of this study is that Korean stroke registry is not in accordance with western medicine. Conclusions : The TOAST classification system is the most widely accepted tool to categorize stroke subtypes in western medicine, but in oriental medicine, it is not yet widely accepted. The authors suggest the general use of the TOAST classification to determine adequate management for stroke patients, to predict the prognosis and recurrence of stroke and to develop a Korean standard of stroke in oriental medicine.

• Journal of Korean Physical Therapy Science
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• v.28 no.2
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• pp.1-9
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• 2021

Background: The requirements for postural and motor control in backward walking training (BWT) may improve balance and walking speed in patients with acute stroke. The aim of this study was to analyze the effect of BWT on balance, balance confidence, and fall efficacy in this population. Design: Randomized controlled pilot trial. Methods: This study included 14 subjects with acute stroke (onset of illness less than one month). They were randomly allocated to a BWT (n=7) or forward walking training (n=7) group and observed five times in a week for a period of two weeks. Measurements were taken before and after the experiment using the Berg balance scale (BBS), Activities-specific balance confidence scale (ABC), and Fall efficacy scale (FES). Results: The BBS, ABC and FES scores obtained in both groups after the experiment were significantly higher than those before the experiment (p<0.05). In addition, the BBS, ABC, and FES scores in the experimental group were significantly higher than those in the control group (p<0.05). Conclusion: These findings indicate that BWT improved balance and balance confidence and decreased the risks of fall in patients with acute stroke. Further study is needed to better understand the effects of backward walking in acute stroke patients.