Nghiên cứu tình trạng rối loạn nhận thức ở người bệnh sau đột quỵ não cấp bằng thang điểm đánh giá tâm thần tối thiểu MMSE tại Khoa Đột quỵ, Bệnh viện Đa khoa tỉnh Ninh Bình năm 2024

Abstract

Objective: (1) To determine the prevalence of post-stroke cognitive impairment (PSCI) in patients after acute stroke using the mini-mental state examination (MMSE). (2) To analyze the correlation between selected clinical, subclinical factors and PSCI in acute stroke patients. Subject and method: A cross-sectional descriptive study was conducted on 383 acute stroke patients (94 hemorrhagic, 289 ischemic) at the Stroke Department - Ninh Binh Provincial General Hospital in 2024. Data were collected via interviews, clinical examination, and MMSE. Data analysis used SPSS 20.0; qualitative variables were presented as percentages (%) with χ2 test; quantitative variables as mean ± standard deviation, min-max, with Student's T-test. p<0.05 was considered statistically significant. Result: The mean age of the study group was 66.7±13.366 years. The overall prevalence of cognitive impairment (MMSE < 24) was 45.95%. Moderate to severe cognitive impairment was significantly more common in hemorrhagic stroke (70.3% of total moderate-to-severe CI) than in ischemic stroke (9.7%, p<0.01). The most affected cognitive domains were recent memory (74.9%) and attention and calculation (56.1%). Factors significantly associated with PSCI included higher age (mean 72.99 ± 10.28 in the CI group), lower educational attainment, history of diabetes (31.2% in the CI group, p=0.01), dominant hemisphere lesion (60.0%), and cortical lesion (85.7% in the CI group, p<0.001). Hemorrhagic stroke patients had a higher prevalence of cognitive impairment than ischemic stroke patients (85.1% vs. 33.2%, p<0.001). Conclusion: Cognitive impairment is a common complication after acute stroke, with a prevalence of 45.95%, and is particularly severe in hemorrhagic stroke patients. Several clinical factors such as age, educational level, diabetes, and brain lesion location (dominant hemisphere, cortical regions) are significantly associated with this condition.