THE ROLE OF IMAGING DIAGNOSIS IN ACUTE CEREBRAL CIRCULATORY FAILURE IN MULTIDISCIPLINARY HOSPITALS ALMATY
Introduction. Acute cerebral circulatory failure (ACCF) remains one of the most serious medical problems of modern society. This condition requires immediate diagnosis and intervention to minimize its consequences and save patients’ lives. This article discusses the important role of imaging diagnostics in the process of detection and evaluation of ACCF, in particular radial diagnostics, especially in multidisciplinary hospitals.
The study aims to analyze cases of acute cerebral circulation disorders and the experience of using radial diagnostics in multidisciplinary hospitals of Almaty.
Materials and methods: The type of research was chosen: quantitative, observational, cross-sectional, analytical, and descriptive. This retrospective study was conducted based on data analysis from "Implementation of the Roadmap for the Introduction of an Integrated Acute Stroke Management Model in Almaty in 2020." A total of 3291 patients with ischemic stroke and 748 patients with hemorrhagic stroke were diagnosed and hospitalized in the stroke units of multi-specialty hospitals - City Clinical Hospital No. 7, City Clinical Hospital No. 4, and the City Emergency Hospital in Almaty. The ethics committee of the Local Ethical Committee of the Kazakhstan Medical University "KSPH" approved this study (IRB –A161 24.03.2022). Research materials were obtained after receiving permission from the institution's management. The leaders were informed about the progress of the study and expressed no objections to its conduct and the publication of its results. Statistical methods included descriptive and analytical techniques. Data analysis was conducted using the MS Excel software package, and visualization was performed using the DataWrapper program.
Results. A study of acute cerebral circulatory disorders in Almaty showed that mortality from stroke increased in 2020 to 16.5% in the City Emergency Hospital and 14.1% in Municipal Clinical Hospital No. 7, driven by the COVID-19 pandemic and associated delays in seeking care. Radiological diagnostics, including MRI (83.0% of patients) and CT (94.0% of patients), proved to be key in treatment management, although access to such services was heterogeneous due to economic barriers. Measures to intensify prevention programs and improve the qualifications of medical personnel are proposed to reduce disability and mortality from stroke, including improved access to diagnosis and primary prevention.
Conclusions: Ischemic stroke is the main cause of mortality among patients with acute cerebral circulatory disorders in multidisciplinary hospitals of Almaty, which requires strengthening the role of primary prevention and improving dispensary practices in urban polyclinics. Radiological diagnostics, including MRI and CT of the brain, is an integral part of stroke diagnosis and treatment in Almaty and plays a key role in determining the type and extent of brain damage. However, despite the widespread availability of these diagnostic methods through budgetary funding, there is still a problem of insufficient coverage of dispensaries due to the redistribution of medical personnel in the context of the pandemic and the closure of medical institutions. This leads to delays in diagnosis and initiation of treatment, which aggravates disease outcomes and increases the risk of mortality among stroke patients. Thus, although radiotherapy is available, systemic healthcare problems limit its effectiveness in controlling stroke at the population level.
Gulzhan M. Adenova1, https://orcid.org/0000-0003-0887-432X
Galina K. Kausova1, https://orcid.org/0000-0001-6857-9563
Alexander V. Brukhanov2, https://orcid.org/0000-0001-7641-6801
1 Kazakhstan Medical University “KSPH”, Almaty, Republic of Kazakhstan;
2 Diagnostic Centre of Altai Krai, Barnaul, Russian Federation.
1. Алдатов Р.Н. Возможности комплексной компьютерной и магнитно-резонансной томографии в ранней диагностике острейшего ишемического инсульта: дисс. …кан. мед. наук. 2022. 152с.
2. Кайратова Г.К., Смаилова Д.С., Hисметова З.А., Серикова-Есенгельдина Д.С., Сарсенбаева Г.Ж., Ахметова К.М. Эффективность реабилитации больных трудоспособного возраста после инсульта. Протокол исследования // Наука и Здравоохранение. 2023. 2(Т.25). С. 41-48. doi:10.34689/Ш.2023.25.2.006.
3. Antipova D., Eadie L., Macaden A., Wilson P. Diagnostic accuracy of clinical tools for assessment of acute stroke: a systematic review // BMC Emerg Med. 2019 Sep 4. 19(1):49. doi: 10.1186/s12873-019-0262-1. PMID: 31484499, PMCID: PMC6727516.
4. Bonkhoff A.K., Grefkes C. Precision medicine in stroke: towards personalized outcome predictions using artificial intelligence // Brain. 2022 Apr 18. 145(2):457-475.
5. Chavva I.R., Crawford A.L., Mazurek M.H., Yuen M.M., Prabhat A.M. et al. Deep Learning Applications for Acute Stroke Management // Ann Neurol. 2022 Oct. 92(4):574-587. doi: 10.1002/ana.26435. Epub 2022 Jul 20. PMID: 35689531.
6. Choi E.Y., Nieves G.A., Jones D.E. Acute Stroke Diagnosis // Am Fam Physician. 2022 Jun 1. 105(6):616-624. PMID: 35704804.
7. Campbell B.C., Parsons M.W. Imaging selection for acute stroke intervention // Int J Stroke. 2018 Aug;13(6):554-567. doi: 10.1177/1747493018765235.
8. El-Koussy M., Schroth G., Brekenfeld C., Arnold M. Imaging of acute ischemic stroke // Eur Neurol. 2014;72(5-6):309-16. doi: 10.1159/000362719. Epub 2014 Oct 14. PMID: 25323674.
9. Herpich F., Rincon F. Management of Acute Ischemic Stroke // Crit Care Med. 2020 Nov;48(11):1654-1663. doi: 10.1097/CCM.0000000000004597. PMID: 32947473; PMCID: PMC7540624
10. Hetts S., Khangura R. Imaging of Acute Stroke: Current State. //Radiol Clin North Am. 2019 Nov;57(6):1083-1091. doi: 10.1016/j.rcl.2019.07.009.
11. Jadhav A.P., Desai S.M., Liebeskind D.S., Wechsler L.R. Neuroimaging of Acute Stroke // Neurol Clin. 2020 Feb. 38(1):185-199. doi: 10.1016/j.ncl.2019.09.004. Epub 2019 Nov 7. PMID: 31761058.
12. Knight-Greenfield A., Nario J.J.Q., Gupta A. Causes of Acute Stroke: A Patterned Approach // Radiol Clin North Am. 2019 Nov. 57(6):1093-1108. doi: 10.1016/j.rcl.2019.07.007. PMID: 31582037; PMCID: PMC704096
13. Meschia J.F., Brott T. Ischemic stroke // Eur J Neurol. 2018 Jan. 25(1):35-40. doi: 10.1111/ene.13409. Epub 2017 Sep 21. PMID: 28800170.
14. Menon BK. Neuroimaging in Acute Stroke. // Continuum (Minneap Minn). 2020 Apr;26(2):287-309. doi: 10.1212/CON.0000000000000839. PMID: 32224753.
15. Musuka T.D., Wilton S.B., Traboulsi M., Hill M.D. Diagnosis and management of acute ischemic stroke: speed is critical // CMAJ. 2015 Sep 8. 187(12):887-93. doi: 10.1503/cmaj.140355. Epub 2015 Aug 4. PMID: 26243819; PMCID: PMC4562827
16. Morgan C.D., Stephens M., Zuckerman S.L., Waitara M.S., Morone P.J. et al. Physiologic imaging in acute stroke: Patient selection // Interv Neuroradiol. 2015 Aug. 21(4):499-510. doi: 10.1177/1591019915587227.
17. Nael K., Yoo B., Salamon N., Liebeskind D.S. Acute Ischemic Stroke: MR Imaging-Based Paradigms. // Neuroimaging Clin N Am. 2021 May 31(2):177-192. doi: 10.1016/j.nic.2021.01.002. PMID: 33902873.
18. WSO global stroke fact sheet. 2022, available: https://www.world-stroke.org/news-and-blog/news/wso-global-stroke-fact-sheet-2022.
19. Yew K.S., Cheng E.M. Diagnosis of acute stroke // Am Fam Physician. 2015 Apr 15. 91(8):528-36. PMID: 25884860.
20. Zeleňák K., Krajina A., Meyer L., Fiehler J. ESMINT Artificial Intelligence and Robotics Ad hoc Committee, Behme D., Bulja D., Caroff J., Chotai A.A., Da Ros V. et al. How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods // Life. 2021. 11(6):488. https://doi.org/10.3390/life11060488
21. Zameer S, Siddiqui AS, Riaz R. Multimodality Imaging in Acute Ischemic Stroke // Curr Med Imaging. 2021. 17(5):567-577. doi: 10.2174/1573405616666201130094948. PMID: 33256582.
22. Zuckerman S.L., Sivaganesan A., Zhang C., Dewan M.C., Morone P.J., et al. Maximizing efficiency and diagnostic accuracy triage of acute stroke patients: A case-control study // Interv Neuroradiol. 2016 Jun. 22(3):304-9. doi: 10.1177/1591019915622167. Epub 2016 Feb 2. PMID: 26842606; PMCID: PMC4984356.
References: [1-2]
1. Aldatov R.H. Vozmozhnosti kompleksnoi kompyuternoi i magnitno-rezonansnoi tomografii v rannei diagnostike ostreishego ishemicheskogo insul'ta [Possibilities of complex computed tomography and magnetic resonance imaging in early diagnosis of acute ischaemic stroke: dissertation]: diss. …kan. med. nauk [Cand Disert]. 2022. 152 p. [in Russian]
2. Kairatova G.K., Smailova D.S., Khismetova Z.A., Serikova-Esengel'dina D.S., Sarsenbaeva G.Zh., Akhmetova K.M. Effektivnost' reabilitatsii bol'nykh trudosposobnogo vozrasta posle insul'ta. Protokol issledovaniya [Effectiveness of rehabilitation of patients of working age after stroke. Research protocol]. Nauka i Zdravookhranenie [Science & Healthcare]. 2023. 2(T.25). pp. 41-48. doi:10.34689/SH.2023.25.2.006. (accessed: 30.04.2023). [in Russian]
Number of Views: 4310
Category of articles:
Original articles
Bibliography link
Adenova G.M., Kausova G.K., Brukhanov A.V. The role of imaging diagnosis in acute cerebral circulatory failure in multidisciplinary hospitals Almaty // Nauka i Zdravookhranenie [Science & Healthcare]. 2024. Vol.26 (2), pp. 60-67. doi 10.34689/SH.2024.26.2.008Related publications:
VALIDATION OF THE KAZAKH VERSION OF THE DEPRESSION ANXIETY STRESS SCALE (DASS-21) IN MEDICAL FACULTY STAFF SAMPLE: THE PILOT STUDY
PREDICTIVE VALUE OF PSYCHOMETRIC TESTING IN CONTEXT OF CREATING ADAPTIVE ENVIRONMENT FOR HIGHER MEDICAL EDUCATION
ASSESSMENT OF STUDENTS' AWARENESS ABOUT THE HARMS OF MICROPLASTICS ON THE HUMAN BODY
THE IMPACT OF COMPLAINTS ON QUALITY OF LIFE, PSYCHOLOGICAL WELL-BEING AND HEALTH OF MEDICAL WORKERS
DEVELOPMENT AND VALIDATION OF A QUESTIONNAIRE FOR PATIENTS "STUDYING THE OPINION OF PATIENTS' SATISFACTION WITH NURSE INDEPENDENT APPOINTMENT AT THE LEVEL OF PRIMARY HEALTH CARE"