Trombolisis intravenosa en accidente cerebro vascular isquémico agudo en un hospital público de Chile: análisis prospectivo de 54 casos
Intravenous thrombolysis for ischemic stroke: experience in 54 patients
Rev. méd. Chile; 144 (4), 2016
Publication year: 2016
Background:
Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) reduces disability in patients with ischemic stroke. However, its implementation in Chilean public general hospitals has been slow and faces some difficulties.Aim:
To analyze the results of an intravenous thrombolysis protocol implementation in a public general hospital.Material and Methods:
During a lapse of 28 months a standardized protocol for intravenous thrombolysis implemented in the emergency room of a public hospital, was prospectively evaluated. Fifty four patients with ischemic stroke were treated and assessed three months later as outpatients.Results:
At three months of follow-up, 66.4% of patients subjected to thrombolysis had a favorable evolution, defined as having 0 to 1 points in the modified Rankin scale. Intracerebral hemorrhage rate was 11.1%, including 5.5% of symptomatic intracerebral hemorrhage. Four percent of patients had systemic bleeding complications after thrombolysis. The mortality rate was 14.8%.Conclusions:
The success rates, mortality, and complications rate were comparable to the results obtained in international studies, despite of the absence of a stroke unit to manage stroke and its complications.
Isquemia Encefálica/tratamiento farmacológico, Fibrinolíticos/uso terapéutico, Accidente Cerebrovascular/tratamiento farmacológico, Terapia Trombolítica/métodos, Activadores Plasminogénicos/uso terapéutico, Encéfalo/diagnóstico por imagen, Isquemia Encefálica/complicaciones, Hemorragia Cerebral/etiología, Hemorragia Cerebral/prevención & control, Progresión de la Enfermedad, Hospitales Públicos, Infusiones Intravenosas, Estudios Prospectivos, Reproducibilidad de los Resultados, Índice de Severidad de la Enfermedad, Accidente Cerebrovascular/complicaciones, Factores de Tiempo, Tomografía Computarizada por Rayos X, Resultado del Tratamiento