FUNCTIONAL STATUS IN PATIENTS WITH HEMORRHAGIC STROKE HOSPITALIZED IN THE INTERNAL MEDICINE DEPARTMENT OF HOSPITAL NACIONAL, 2023–2024

Abstract

Introduction: Hemorrhagic stroke is a cerebrovascular disorder characterized by the extravasation of blood into the intracranial cavity, resulting in a sudden-onset neurological deficit. Its frequency increases with age. In Paraguay, cerebral hemorrhage accounts for 23.3% of cerebrovascular accidents. The Barthel Index assesses physical disability and estimates an individual's degree of functional independence. Objective: To determine the functional status of patients hospitalized for hemorrhagic stroke in the Department of Internal Medicine at Hospital Nacional between 2023 and 2024. Materials and methods: This was an observational, descriptive, cross-sectional, retrospective study involving patients diagnosed with hemorrhagic stroke and hospitalized at Hospital Nacional between 2023 and 2024. Patients older than 18 years were included, while those with incomplete medical records were excluded. Non-probability consecutive sampling was used. The variables analyzed included sociodemographic characteristics (age, sex, and place of residence) and clinical characteristics (comorbidities, hemorrhagic stroke severity according to the Glasgow Coma Scale, and functional status at hospital discharge assessed using the Barthel Index). Results: A total of 243 patients with hemorrhagic stroke were included. Ages ranged from 26 to 92 years, with a median age of 65 years. Male patients predominated (64%). The most frequent comorbidity was arterial hypertension (49%), followed by obesity and smoking. Mild impairment of consciousness, according to the Glasgow Coma Scale, was observed in 79.3% of patients. According to the Barthel Index, 37% had moderate dependence at hospital discharge, while 20% achieved functional independence. The mortality rate was 18%. Conclusion: Hemorrhagic stroke was more frequent among men, with a median age of 65 years. Most patients presented with mild impairment of consciousness. At hospital discharge, moderate functional dependence was the most frequent category, accounting for 37% of cases. These findings demonstrate a substantial burden of hemorrhagic stroke at the institution studied and highlight the importance of assessing patients' functional status.