Stroke Severity and Nursing Care Complexity: A 2-year Analysis From a Comprehensive Stroke Unit in a Middle-income...

Nursing care complexity is a critical determinant of safety and quality of care in stroke management.

This retrospective cross-sectional study evaluated the care complexity and its association with neurological impairment among patients admitted to a comprehensive stroke unit.

This study analyzed a database of patients with stroke. Care complexity was assessed using the Fugulin scale. Occupancy rate and required nursing staff were calculated according to the Fugulin scale care profile. Neurological impairment was measured at admission using the National Institutes of Health Stroke Scale (NIHSS). A multiple regression model was used to test the association between Fugulin and NIHSS scores across 3 models: model 1 (NIHSS only), model 2 (NIHSS, age, sex, and treatment), and model 3 (NIHSS, age, sex, stroke type, and treatment).

Most patients required high-dependency care. Optimal care delivery demanded 5 nurses and 8 nursing technicians. NIHSS score was positively associated with Fugulin score in all models (P<.001). Age was also positively associated with care complexity (P<.001). In contrast, reperfusion therapy with combined thrombolysis and thrombectomy was negatively associated with Fugulin score (model 2: P=.016; model 3: P=.035).

Nursing care complexity exceeded national recommendations. Stroke severity and older age increased demands, whereas cerebral reperfusion reduced them.