Republic of the Philippines

TARLAC STATE UNIVERSITY

COLLEGE OF SCIENCE
NURSING DEPARTMENT
Lucinda Campus, Brg.Ungot, Tarlac City Philippines 2300
Tel.No: (045) 493-1865 Fax: (045) 982-0110 website: www/tsu.edu.ph

Journal
(Stroke and stroke risk factors in women of reproductive age with
a history of metabolic or bariatric surgery)

Castro, Patricia Kaye,Tayag

BSN4-1/G1
 SOURCE:
Journal of Stroke and Cerebrovascular Diseases
Volume 31, Issue 12, December 2022, 106814
https://www.sciencedirect.com/science/article/abs/pii/S1052305722005080

INTRODUCTION:
When anything prevents blood flow to a portion of the brain or when a blood artery in the brain
bursts, a stroke, also known as a brain attack, happens. The brain either ages or suffers harm in
both scenarios. A stroke may result in permanent brain damage, chronic disability, or even
fatality.

Stroke prevalence increases with age and is comparable between males and females overall, at
2.5% and 2.6%, respectively. However, women have a higher lifetime risk of stroke, with 55,000
more women than men experiencing stroke each year. Stroke continues to be a leading cause of
morbidity and mortality It is more common in older adults. Additionally, stroke prevalence is
somewhat higher in women than in males during the reproductive years, which is concerning for
women who intend to get pregnant. According to a 2020 American study, women aged 25 to 44
had a higher stroke risk than men in the same age range. Similarly, major contributing factors to
stroke include elements linked to other comorbid conditions that must be managed prior to,
during, between, and beyond pregnancy.
According to the Global Burden of Disease Study conducted in 2013, a poor diet (particularly
one with a low intake of fruits and vegetables), high blood pressure, and a high body mass index
(BMI) are the three main risk factors for stroke in high-income North American nations like the
United States. Furthermore, female sex hormones, including those raised or changed by oral
contraception, are linked to a higher risk of stroke. For women using oral contraceptives,
Salisbury and colleagues explain risk variables; maybe not unexpectedly, high levels of
hormones, notably estrogen, along with obesity and/or hypertension increase the risk.
Additionally, migraine with aura is linked to a higher risk of stroke, while the exact mechanism
is unknown. Together, a number of risk factors for stroke emerge specific to females compared
to their male counterparts. The increased prevalence of stroke among women of reproductive
age, regardless of pregnancy status, has not been attributed to increased vascular morbidity; the
differences in stroke risk between men and women are more likely linked to non-vascular
contributors, like obesity and female sex hormones.
A lot of people have metabolic/bariatric surgery (MBS) to control and lower their risk of stroke
and other chronic illnesses. Women represent for 70% to 80% of MBS cases, making them
substantially more likely than males to explore and undergo the procedure. MBS improves
hypertension, dyslipidemia, vascular complications (especially when linked to Type II Diabetes),
BMI, and lowers the risk of all-cause mortality. Women are also more likely to be of
reproductive age at the time of surgery.
Given the extensive range of advantages and the high prevalence of chronic disease, it is not
unexpected that MBS is becoming more popular. Although women of reproductive age are more
likely than males to experience a stroke and are also more likely to receive MBS, data on the
association between stroke and MBS for women of reproductive age is scarce. In 2018, there
were 94,000 more MBS procedures performed than there were in 2011. Similar to this, even
though MBS has several benefits that are well known, there is still area for debate on how MBS
affects young women's stroke risk.
To broaden evidence in this area, the objective of the current study was to determine if there
were differences in occurrence of stroke or presence of stroke risk factors in women who had
MBS compared to women without a history of MBS.

PROCEDURES:

The National Inpatient Sample (NIS), a publicly accessible dataset from the Healthcare Cost and
Utilization Project (HCUP), is used by the study team. The NIS uses a stratified design to sample
the hospital discharges, and each year's data has a weighted total of about 35 million discharges.
Data from 2012 through 2017 were used for this study; these years were selected so that they
would include data from the time the sampling.

Table 1 lists the properties of a sample. The sample had a high percentage of white people
(61.57%), and the women with MBS histories were older than the non-MBS women (mean age
37.21 years (SD = 5.43) vs. 33.59 years (SD = 7.20), t = -296.72, p 0.001). Women with MBS
mostly used private insurance (47.68%) whereas women without MBS mostly used government
insurance (46.34%), 2 = 1791.84, p 0.001. Depression chances were greater for MBS women
(OR = 1.84, 95%CI).

FINDINGS & CONCLUSIONS:

In this study, a group of women of reproductive age was examined to determine the effect of
MBS on stroke and stroke risk variables. Compared to women without a history of MBS, women
with a history of MBS had a 40% lower chance of developing diabetes, which included patients
with both Type I and Type II diabetes. Additionally, diabetes was found to raise the risk of
stroke in the current study for Latinas, but not for Black or white women. MBS has been
recommended for individuals.

Most studies that focus on stroke are concerned with the impact of MBS on obstructive sleep
apnea and/or atrial fibrillation as precursors to stroke, which was outside the scope of the current
study. Previous research has focused on the impact of MBS on several health outcomes, but there
is little research focused on the impact of MBS on stroke risk in general. The current study's
findings are in line with studies on how MBS affects diabetes, hypertension, and other
conditions.

PERSONAL COMMENTS:

Every year, almost 800,000 people worldwide suffer from a stroke, with around three in four of
these cases being first-time cases. Additionally, strokes are the main contributor to long-term
disability and the main preventable cause of disability.Stroke can have an impact on activities
due to paralysis, poor coordination, loss of feeling, lack of awareness or neglect of one side of
the body, as well as trouble starting a movement or organizing a series of motions.

This study will help future nurses analyze or investigate the stroke study and help future patients
prevent some erorr and complication that may cause. Patients who use it can have a proper care
What are the medicines, treatments, foods, etc. that the patient can do. This study inspires me to
do more research about stroke like why it has many side effects in putting or error in patient.
This is related to RLE skills/clinical because it shows the reality about the use of these method
and the effect of the treatment and nursing care to the patient.