Sánchez MJR, Cruz LC, Trejo GJF

Language: Spanish
References: 22
Page: 124-131
PDF size: 206.37 Kb.

ABSTRACT

The acute ischemic stroke is the leading cause of disability in adults, and the second cause of death in the world. Thirty – day fatality rates for ischemic stroke in Western societies generally range between 10 and 17%. The guidelines for treatment of acute ischemic stroke recommend the use of recombinant tissue plasminogen activator starting within 3 hours after the onset of symptoms. The delay in clinical and tomographic evaluation is the most important cause of exclusion of thrombolytic treatment. We study the critical times for thrombolysis in patients with acute ischemic stroke.
Methods: This is a prospective, observational, transversal, descriptive, analytic study. This study included all patients with diagnosis of acute ischemic stroke in the period between july 2007 – july 2008. We observed the critical times of hospital arrive, clinical and tomographic evaluation and neurologist evaluation, and rates of thrombolysis.
Results: Of 110 patients with ischemic stroke, 12 (10%) finished their evaluation before the 180 min limit. Only 6 patients (5%) received thrombolysis. In both groups, the ‹ 180 min evaluation and the › 180 min evaluation; the leading cause of delay at the in-hospital evaluation was the neurologist evaluation.
Conclusion: We recommend that thrombolysis indications shouldn’t depend of neurologist evaluation. It should be indicated for any physician with training in the evaluation of critical patients and cranial tomography evaluation, principally Internal medicine, Critical care, and emergency medicine specialists.

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