Untreated stroke timeline
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Consequences and Timeline of Untreated Stroke
Introduction to Untreated Stroke
Stroke is a critical medical condition that requires immediate intervention to minimize long-term damage and improve patient outcomes. However, untreated stroke, whether due to delayed medical attention or lack of access to healthcare, can lead to severe consequences. This article synthesizes research findings on the timeline and impact of untreated stroke, highlighting the importance of timely medical intervention.
Economic and Health Burden of Untreated Stroke
Impact of COVID-19 on Stroke Care
The COVID-19 pandemic has significantly disrupted emergency care services, including those for stroke patients. A scoping review identified a substantial decrease in emergency care for ischemic stroke during the pandemic, with a 20% reduction in emergency care visits, a 32% decrease in endovascular procedures, and a 5.5% drop in thrombolysis indications. This reduction in care has led to more severe strokes, increased disability, higher rehabilitation costs, and longer hospital stays for untreated stroke patients.
Increased Disability and Mortality
Untreated stroke patients are more likely to experience severe disability and functional dependence within 6-12 months post-stroke. Specifically, there is a 13% increase in severe disability and a 12% rise in functional dependence among these patients. Additionally, untreated stroke patients have a 16.6% higher likelihood of cognitive disability and a 4-6% increased risk of death compared to those treated with thrombolysis.
Risk Factors and Outcomes in Untreated Stroke
Hypertension and Hemorrhagic Stroke
Hypertension is a significant risk factor for hemorrhagic stroke, which includes intracerebral and subarachnoid hemorrhages. Research indicates that untreated hypertension significantly increases the risk of hemorrhagic stroke, with an odds ratio (OR) of 3.5 compared to 1.4 for treated hypertension. It is estimated that 17% to 28% of hemorrhagic strokes among hypertensive patients could be prevented with proper hypertension management.
Blood Pressure Control in Hypertensive Patients
A study assessing the risk of stroke in hypertensive patients found that only 18.4% of treated hypertensive patients achieved controlled blood pressure levels, with even lower control rates in patients with left ventricular hypertrophy and diabetes. The average 10-year stroke risk in hypertensive patients was 17%, emphasizing the need for better blood pressure management to prevent strokes.
Management of Unruptured Brain Arteriovenous Malformations (BAVM)
Comparing Treated and Untreated BAVM Patients
The management of unruptured brain arteriovenous malformations (BAVM) remains controversial. Observational data from the Multicenter AVM Research Study (MARS) showed a trend towards increased risk of adverse events, including stroke and death, in treated BAVM patients compared to those managed medically. However, a subgroup analysis suggested that patients with a higher propensity for treatment might benefit from intervention, indicating the need for larger studies to develop risk stratification models.
Conclusion
The consequences of untreated stroke are severe, leading to increased disability, higher healthcare costs, and greater mortality. The COVID-19 pandemic has exacerbated these issues by reducing access to timely stroke care. Effective management of hypertension and careful consideration of treatment options for conditions like BAVM are crucial in mitigating the risks associated with untreated stroke. Immediate and appropriate medical intervention remains essential to improve outcomes for stroke patients.
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