Author/Editor		Goljar, Nika; Bizovičar, Nataša; Adlešič, Barbara; Čanč, Tanja
Title		Ali novi načini zdravljenja v akutnem obdobju možganske kapi prinašajo spremembe pri rehabilitaciji bolnikov?
Translated title		Are new treatment methods in the acute phase of stroke bringing changes in the rehabilitation of those patients?
Type		članek
Vol. and No.		Letnik 17, št. 1
Publication year		2018
Volume		str. 4-11
ISSN		1580-9315 - Rehabilitacija
Language		slv
Abstract		Izhodišča: V zadnjih 15 letih je pri zdravljenju akutne možganske kapi (MK) prišlo do velikega napredka. Namen študije je ugotoviti, ali se je zaradi tega spremenilo napotovanje bolnikov v Triažno ambulanto za bolnike po možganski kapi (Triažna ABMK) na Univerzitetnem rehabilitacijskem inštitutu Republike Slovenije-Soča (URI-Soča). Metode: V retrospektivno raziskavo smo vključili bolnike po MK, ki so bili prvič pregledani v Triažni ABMK v obdobju od 1. januarja do 31. decembra 2007 ter v obdobju od 1. januarja 2015 do 31. oktobra 2015. Iz razpoložljive medicinske dokumentacije smo zbrali sociodemografske podatke, podatke o vrsti, trajanju in načinu zdravljenja bolezni, o ustanovi, iz katere so bili bolniki napoteni, specialnosti napotnega zdravnika ter ukrepih, določenih pri triažnem pregledu. Rezultati: Statistično značilne razlike pri bolnikih, pregledanih leta 2015, v primerjavi s tistimi, pregledani leta 2007, so bile: daljši čas od nastopa MK do pregleda v Triažni ABMK (p<0,001), krajši čas od ambulantnega pregleda do sprejema na URI-Soča (p<0,001), večji delež bolnikov, ki so prestali urgentno fibrinolitično zdravljenje (p<0,001), večji delež bolnikov z obojestransko nevrološko okvaro (p<0,050), manjši odstotek bolnikov, napotenih iz obeh univerzitetnih kliničnih centrov, večji odstotek bolnikov, napotenih iz regijskih bolnišnic (p<0,001), večji delež specialistov nevrologov in specialistov fizikalne in rehabilitacijske medicine med napotnimi zdravniki (p<0,001), večji delež bolnikov, ki niso izpolnjevali meril za sprejem na URI-Soča (p<0,001) in večji delež bolnikov, napotenih v Center za poklicno rehabilitacijo (p<0,010). Zaključek: Sklepamo, da se ob novih postopkih zdravljenja in organiziranosti zdravstvenih služb spreminja tudi populacija bolnikov po MK, usmerjenih na rehabilitacijo na URI-Soča. Nanizane so možnosti za nadaljnje vodenje rehabilitacijskih programov bolnikov po MK.Introduction: There have been remarkable advances in acute stroke treatment in the last 15 years. The purpose of our study was to determine whether this has changed the referral of patients to the triage outpatient clinic for patients after stroke at the University Rehabilitation Institute (URI) in Ljubljana. Methods: In this retrospective study, we included patients after stroke who were first examined in our triage outpatient clinic in the period from January 1 to December 31, 2007, and from January 1, 2015, to October 31, 2015. From the available medical documentation, we collected socio-demographic data, data on the type, duration and method of treatment of the disease, the institution from which the patients were referred, the specialties of the referral physicians, and the measures set out during examination in the triage outpatient clinic. Results: Statistically significant differences in patients examined in 2015 as compared to those examined in 2007 were: longer period of time from the occurrence of stroke up to time of examination in the triage outpatient clinic (p<0.001), shorter time from outpatient examination to admission to the URI (p<0.001), higher proportion of patients who had undergone urgent fibrinolytic treatment (p<0.001), higher proportion of patients with a two-sided neurological impairment (p<0.050), lower proportion of patients sent from both University Medical Centres and higher proportion of patients arriving from regional hospitals in Slovenia (p<0.001), higher proportion of neurologists and PRM specialists among referral physicians (p<0.001), higher proportion of patients who did not meet the criteria for admission to the URI (p<0.001), and higher proportion of patients referred to the Centre for Vocational Rehabilitation. Conclusions: We believe that new treatment procedures and better organisation of health services have also changed the population of stroke patients directed to rehabilitation at our institute. We present options for further organisation of rehabilitation programmes for patients after stroke.
Descriptors		Stroke Rehabilitation methods
Keywords		stroke rehabilitation referrals rehabilitation management možganska kap rehabilitacija napotitev vodenje rehabilitacije