In-hospital stroke: a multi-centre prospective registry
Por:
Vera, R, Lago, A, Fuentes, B, Gallego, J, Tejada, J, Casado, I, Purroy, F, Delgado, P, Simal, P, Marti-Fabregas, J, Vivancos, J, Diaz-Otero, F, Freijo, M, Masjuan, J
Publicada:
1 ene 2011
Resumen:
Background:
In-hospital strokes (IHS) are relatively frequent. Avoidable delays in neurological assessment have been demonstrated. We study the clinical characteristics, neurological care and mortality of IHS.
Methods:
Multi-centre 1-year prospective study of IHS in 13 hospitals. Demographic and clinical characteristics, admission diagnosis, quality of care, thrombolytic therapy and mortality were recorded.
Results:
We included 273 IHS patients [156 men; 210 ischaemic strokes (IS), 37 transient ischaemic attacks (TIA) and 26 cerebral haemorrhages]. Mean age was 72 +/- 12 years. Cardiac sources of embolism were present in 138 (50.5%), withdrawal of antithrombotic drugs in 77 (28%) and active cancers in 35 (12.8%). Cardioembolic stroke was the most common subtype of IS (50%). Reasons for admission were programmed or urgent surgery in 70 (25%), cardiac diseases in 50 (18%), TIA or stroke in 30 (11%) and other medical illnesses in 71 (26%). Fifty-two per cent of patients were evaluated by a neurologist within 3 h of stroke onset. Thirty-three patients received treatment with tPA (15.7%). Thirty-one patients (14.7%) could not be treated because of a delay in contacting the neurologist. During hospitalization, 50 patients (18.4%) died, 41 of them because of the stroke or its complications.
Conclusions:
Cardioembolic IS was the most frequent subtype of stroke. Cardiac sources of embolism, active cancers and withdrawal of antithrombotic drugs constituted special risk factors for IHS. A significant proportion of patients were treated with thrombolysis. However, delays in contacting the neurologist excluded a similar proportion of patients from treatment. IHS mortality was high, mostly because of stroke.
Filiaciones:
Lago, A:
Hosp La Fe, E-46009 Valencia, Spain
Fuentes, B:
Hosp La Paz, Madrid, Spain
Gallego, J:
Hosp Navarra, Pamplona, Spain
Tejada, J:
Hosp Leon, Leon, Spain
Casado, I:
Hosp San Pedro de Alcantara, Caceres, Spain
Purroy, F:
Hosp Arnau Vilanova, Lleida, Spain
Delgado, P:
Hosp Valle De Hebron, Barcelona, Spain
Simal, P:
Hosp Clin San Carlos, Madrid, Spain
Marti-Fabregas, J:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Vivancos, J:
Hosp La Princesa, Madrid, Spain
Diaz-Otero, F:
Hosp Gregorio Maranon, Madrid, Spain
Freijo, M:
Hosp Basurto, Vizcaya, Spain
Masjuan, J:
Hosp Ramon & Cajal, Unidad Ictus, E-28034 Madrid, Spain
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