TY - JOUR
T1 - Urgent stroke care in hospitals with a stroke unit. Quick project
AU - Masjuán, Jaime
AU - Álvarez-Sabín, José
AU - Arias-Rivas, Susana
AU - Blanco, Miguel
AU - de Felipe, Alicia
AU - Escudero-Martínez, Irene
AU - Fuentes, Blanca
AU - Gállego-Culleré, Jaime
AU - Moniche-Álvarez, Francisco
AU - Muñoz, Lucía
AU - de la Ossa-Herrero, Natalia Pérez
AU - Sahuquillo, Patricia
AU - Santamarina, Estevo
AU - Sanz, Borja
AU - Tembl, José I.
AU - Zandio, Beatriz
PY - 2016/1/1
Y1 - 2016/1/1
N2 - © 2016 Revista de Neurología. Introduction. A stroke is a time-dependent medical emergency. Swiftness in its recognition and in the care received by the patients plays a key role in the prognosis. Aims. To analyse the medical intervention times, to evaluate possible areas where improvements can be made and to examine the allocation of resources in the centres. Patients and methods. The study was based on a prospective register of patients with suspected stroke and stroke code activation treated in eight experienced Spanish stroke units. Onset-to-door, door-to-computed tomography (CT), door-toneedle, CT-to-needle and onset-to-needle times were collected. Information about the means of transport used to get to the hospital, the type of stroke and reperfusion therapies was also collected. With regard to the structural resources of the centres, data were gathered about the nurse-to-patient ratio, bed monitoring, availability of multimodal CT and magnetic resonance, and doing information or training courses. Results. Altogether 197 patients were included, of whom 181 (151 infarctions and 30 brain haemorrhages) were valid. The medians (p25-p75) in minutes were: onset-to-door, 104 (70-188); door-to-CT, 27 (19-41); CT-to-needle, 30 (21-43); doorto- needle, 64 (49-83); and onset-to-needle, 156 (129-202). Reperfusion therapies were applied in 68 patients (45% of the cerebral infarctions), of which 81% were intravenous thrombolyses; 7%, endovascular treatments; and 12%, a combination of the two. The resources available in the centres were in accordance with those recommended by the clinical guidelines. There was a low percentage of patients who were studied by means of magnetic resonance. Conclusion. The percentage of patients treated with thrombolysis was very high and although the times of the in-hospital circuits were good, there is still room for further improvement.
AB - © 2016 Revista de Neurología. Introduction. A stroke is a time-dependent medical emergency. Swiftness in its recognition and in the care received by the patients plays a key role in the prognosis. Aims. To analyse the medical intervention times, to evaluate possible areas where improvements can be made and to examine the allocation of resources in the centres. Patients and methods. The study was based on a prospective register of patients with suspected stroke and stroke code activation treated in eight experienced Spanish stroke units. Onset-to-door, door-to-computed tomography (CT), door-toneedle, CT-to-needle and onset-to-needle times were collected. Information about the means of transport used to get to the hospital, the type of stroke and reperfusion therapies was also collected. With regard to the structural resources of the centres, data were gathered about the nurse-to-patient ratio, bed monitoring, availability of multimodal CT and magnetic resonance, and doing information or training courses. Results. Altogether 197 patients were included, of whom 181 (151 infarctions and 30 brain haemorrhages) were valid. The medians (p25-p75) in minutes were: onset-to-door, 104 (70-188); door-to-CT, 27 (19-41); CT-to-needle, 30 (21-43); doorto- needle, 64 (49-83); and onset-to-needle, 156 (129-202). Reperfusion therapies were applied in 68 patients (45% of the cerebral infarctions), of which 81% were intravenous thrombolyses; 7%, endovascular treatments; and 12%, a combination of the two. The resources available in the centres were in accordance with those recommended by the clinical guidelines. There was a low percentage of patients who were studied by means of magnetic resonance. Conclusion. The percentage of patients treated with thrombolysis was very high and although the times of the in-hospital circuits were good, there is still room for further improvement.
KW - Cerebral infarction
KW - Reperfusion
KW - Stroke
KW - Stroke code
KW - Stroke unit
KW - Thrombolysis
M3 - Article
SN - 0210-0010
VL - 62
SP - 303
EP - 310
JO - Revista de Neurologia
JF - Revista de Neurologia
IS - 7
ER -