Stroke Cases : Chances to recovery back to normal.

Stroke Cases : Chances to recovery back to normal.

According to the latest WHO data published in may 2014 Stroke Deaths in Malaysia reached 15,497 or 12.19% of total deaths. The age adjusted Death Rate is 80.59 per 100,000 of population ranks Malaysia #97 in the world. Review other causes of death by clicking the links below or choose the full health profile.

1.        Overview of Stroke.

 Stroke is a devastating illness and is the most common cause of severe disability in adult. The average incidence of stroke is about 2:1,000 population, and the risk of stroke increases with age such that after the fifth decade, the incidence doubles with every decade of life.

Data from the Framingham study showed that the incidence of stroke rises exponentially from 1 to 2 per 1,000 in the 45 to 54 years old age group to nearly 10 per 1,000 in the 65- to 74 years old age group. For persons of 75 to 84 years old, the incidence rises to nearly 20 per 1,000. As the incidence increases with age, so too is the prevalence. Stroke prevalence is about 6:1,000 population and prevalence of stroke disability is 4:1,000.

In developed countries, the incidence of stroke has been steadily decreasing since 1960’s and the initial fall in incidence was largely attributed to better control of hypertension. Subsequent fall in incidence was due to better control of other risk factors such as heart disease, diabetes, smoking and obesity. However stroke remains a major cause of death and consistently the third most common cause of death after heart disease and cancers. The economic and psychosocial cost of stroke is tremendous.

In the USA it is estimated that there are 3 million stroke survivors, with nearly 0.5 million new or recurrent strokes per year. The cost of treatment and rehabilitation is about US 40 billions per year.

the proportion of people above 60 years old was 6.1%. In future as longevity continues to improve, the proportion of senior citizens will reach 15-20% or more as in developed countries now.

 A study done in the University Hospital showed 400 stroke cases per year, of which 71% were due to infarcts (31.8% large vessels, 39.2% small vessels) and 19% due to haemorrhage.

In Kuala Lumpur Hospital (KLH) 1,000 stroke cases are seen per year with 30-35% acute mortality. Cerebral infarcts formed 60.8% of cases (53% large vessels, 7.8% small vessels) and 33% were due to haemorrhage. The higher percentage of haemorrhage seen in KLH was probably due to the availability of neurosurgical service which was not available in the University Hospital at the time of the study.

2.       Prognosis of Stroke.

The prognosis of stroke depends on the stroke type, size and location of stroke. Best prognosis is seen in lacunar stroke with 85% chance of full recovery and the worst prognosis is in cerebral haemorrhage with acute mortality rate of 60-80%. For larger cerebral infarcts, the mortality rate is 20-30% depending on the size and location of the infarct. Brain stem infarcts and large hemisphere infarcts carry a worse prognosis.

In developed countries, acute mortality of stroke has also been decreasing but in recent years the rate of improvement is leveling off and the mortality figures are reaching plateau. The initial improvements were attributed to better general care of stroke patients and further improvement can be expected with better definitive or specific treatments such as thrombolytic and neuroprotective therapies.

Overall, about 12% of stroke patients die.

In countries with comprehensive service for stroke care, about 60% of stroke survivors are discharged home, 15-20% discharged to rehabilitation hospitals and 20-25% discharged to institutions for long-term care.

In terms of morbidity and mortality among patients who survived longer than 6 months, 32% have depression, 48% hemiparetic, 22% cannot walk, 12-18% dysphasic and 24-53% require partial or complete assistance for Activities of Daily Living (ADL).

In a study at KLH in 1995 among patients with first stroke, acute mortality (within 2 weeks) was 29%. At discharge, 47% were bedridden, 22% were wheelchair-bound, 86% had feeding problems, 36% had speech problems and 32% had bladder problems.

“The initial improvements were attributed to better general care of stroke patients and further improvement can be expected with better definitive or specific treatments such as thrombolytic and neuroprotective therapies.”

The above statement quote by the medical researcher about the possibility to rehabilitate the patient to recover back almost back to normal person. Is it possible?

My dear friends, through my own experience of taking care my stroke wife almost come to the 16^th years to date. I am very confident that the caregiver of the stroke patient play an important role to assist the patient faster their healing process and able to recover back to normal person.

This experience to be publish by next year and I hope it can be one of the references to all my dear friend who just facing a tragic incidence when your lover spouse suddenly attack by stroke. A lot of tragic reeling and depression will faces by patient herself and also the pain and sorrow will be facing by the spouse who  to be a closed sibling whose will take care the stroke survivor.

My experience of taking care of acute stroke patient it seem that the most important thing is that the caregiver must take a positive attitude to suit himself with the challenge and sorrow to be facing for the long period of times to take care and assistance for activity of daily living (ADL) of the stroke patient.

Due to long time taken for the healing process.  Caregiver must has a patience attitude. He should be vary patience to take care with full heart and sincerely, this is very important because it will be the most important factor to help the healing process for depression and recovery the damage of the brain.

I hope all the reader will follow my write up from time to time in my blog. InsyaAllah I will try my best to post at least one topic per day regarding of my experience of taking care my stroke wife. Who is now at the position to recover back nearly 95% back to normal, Allamdulillah (thanks God).

Wallahu'lam.