• Journal of Korean Neurosurgical Society
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• v.50 no.1
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• pp.1-5
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• 2011

Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.258-264
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• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• Health Policy and Management
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• v.26 no.4
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• The Journal of the Society of Stroke on Korean Medicine
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• v.11 no.1
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• pp.46-54
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• 2010

Objective : The purpose of this study was to investigate the characteristics of the acute stroke patient who take Yanggyeoksanhwa-tang, and arrange the indication of Yanggyeoksanhwa-tang. Method : We studied hospitalized patients within 4 weeks after their accident who were hospitalized at Kyunghee University Oriental Medical Center, Kyunghee University East-West Neo Medical Center, Kyungwon University Oriental Medical Center, Semyung University Oriental Medical Center from February 2010 to July 2010. We classified and found out the characteristics of acute stroke patient according to herb medicine. Result : The patient who take Yanggyeoksanhwa-tang show meaningful difference for TG, HDL-cholesterole, total lipid, AST, homocysteine, chest burning sensation, and oriental medical diagnosis. Conclusion : The result of this study show that Yanggyeoksanhwa-tang can be applied to acute stroke patient who feels chest burning sensation, and whose oriental medical diagnosis is fever type. Additory evaluations would be needed to better understand the difference between Yanggyeoksanhwa-tang group and other herb medicine group on acute stroke patients.

• International Journal of Advanced Culture Technology
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• v.6 no.4
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• pp.124-130
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• 2018

Proper management and prevention of dysphagia are urgently needed in acute care of stroke patients in Korea. However, no highly sensitive and accessible nurse-led screening tools have been validated within the Korean settings. The purpose of this study was to validate a screening tool led by nurses to identify dysphagia and aspiration risks among acute stroke patients. Registered nurses (RNs) screened 131 residents from a university hospital in South Korea using the Korean version of the Standardized Swallowing Assessment (K-SSA). Results were validated against those from the Gugging Swallowing Screen (GUSS). Compared to results from the GUSS, with 9- and 14-point cutoffs, the K-SSA had a sensitivity of 0.80 and specificity of 0.90 [95% CI 0.806, 0.992] for screening dysphagia and 1.00 sensitivity and 0.94 specificity [95% CI 0.862, 1.000] for screening aspiration risks. The K-SSA demonstrated excellent sensitivity and specificity for screening individuals at risk of dysphagia and aspiration when led by RNs for acute stroke patients.

• The Journal of the Convergence on Culture Technology
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• v.5 no.1
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• pp.417-428
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• 2019

The aims of this study were to evaluate the prevalence of dysphagia in patients hospitalized with acute stroke and to identify factors associated with dysphagia. The study was conducted in a tertiary hospital and a total of 131 patients hospitalized with acute stroke (aged 34-92 years old, 58.0% male) were enrolled. The prevalence of dysphagia was 24.4% out of 131 participants and risk factors associated with dysphagia were age, neurological severity, oral health status, and dependence in activity of daily living of participants. Considering the long-term rehabilitation trajectory, it is necessary to apply the early screening and preventive nursing intervention for dysphagia during acute stage of stroke patient.

• Quality Improvement in Health Care
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• v.27 no.1
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• pp.43-50
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• 2021

Purpose: The aim of this study was to determine the effect of side walking on balance confidence, falls efficacy and fall risk in acute stroke patients. Methods: The study included 14 patients with acute stroke who were randomly allocated to a side walking group (Experimental group, N=7) and a forward walking group (Control group, N=7). Both groups performed the exercise 5 times a week for 2 weeks. Outcomes were assessed using Korean-Activities-specific Balance Confidence Scale (K-ABC), Korean-Fall Efficacy Scale (K-FES), Korean-Fullerton Advanced Balance Scale (K-FAB). Results: After 2 weeks of training, both groups showed significantly improved ABC, FES, FAB (p<.05 in both groups). However, the ABC, FES, FAB in the experimental group was significantly better than in the control group (p<.05). Conclusion: These findings indicate that side walking training may be effective at improving balance confidence and decreasing fall down risk in early stroke patients. Therefore, side walking training may be recommended as an intervention in reducing the incidence of falls in acute stroke patient.

• The Journal of Korean Medicine
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• v.28 no.2 s.70
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• pp.241-246
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• 2007

Objectives : This study investigated stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in two groups divided by age according to the weakness of shingi (shenqi): younger (40 to 63 years) and older (= 64 years). Methods : 165 male patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. Stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in two age groups were examined. Results : Mean ages were $53.01{\pm}6.16$ and $70.95{\pm}6.37$ years for the younger 77 patients and older 88 subjects, respectively. There were no significant differences in stroke type, ischemic stroke subtypes, stroke complications and Sasang constitutions. Current smoking was more frequent in the younger age group (P= 0.005). Conclusion : Age does not seem to influence stroke types, ischemic stroke subtypes, stroke risk factors (except current smoking), stroke complications or Sasang constitutions.

• Korean Journal of Adult Nursing
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• v.19 no.1
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• pp.45-54
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• 2007

Purpose: This study was to identify the significant acute physiological predictors of mortality and of functional and cognitive recovery in hemorrhagic stroke patients. Methods: The subjects were 108 hemorrhagic stroke patients admitted to Neurological Intensive Care Unit of a university hospital. Results: The significant physiological predictors of mortality and of functional and cognitive recovery were quite different upon admission Glasgow Coma Scale scores: respiratory rate, hematocrit, serum pH, osmolality, and $PaCO_2$ were the predictors in the subjects with a high Glasgow Coma Scale scores while blood pressure, $PaO_2$, respiratory rate, and hematocrit in the subjects with a low Glasgow coma scale scores. Conclusion: The physiological derangements induced by acute stroke are undoubtedly influence clinical outcome. More study is required to determine their diverse impacts on clinical outcomes.

• The Journal of the Society of Stroke on Korean Medicine
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• v.12 no.1
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• pp.32-40
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• 2011

Objective : The aim of this study was to examine Differences of overall characteristics depending on Symptom Severity in Acute Stroke Patient Method : We studied hospitalized patients within 10days after their ictus who were admitted at Kyunghee University Oriental Medical Center from May 2011 to October 2011. We compared the general characteristics of acute stroke patient according to Scandinavian Stroke Scale score Result : The patient who had mild severity show significant difference for FBS, PP2, Homocysteine, Exercise, Tongue color, Mouth dryness, Chest discomfort, Constipation, Stool hardness. Conclusion : The above result contribute to predict severity of stroke symtoms according to risk factor and general condition of patients. Also, After occurrence of stroke, We will can block worsening of symptoms progression. Further studies will be needed to observation of follow up studies about progression of stroke among acute stroke patients with a serious disability.