Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Más filtros











Intervalo de año de publicación
1.
Rev. neurol. (Ed. impr.) ; 52(8): 457-464, 16 abr., 2011. tab, graf
Artículo en Español | IBECS | ID: ibc-89060

RESUMEN

Introducción. La trombólisis endovenosa en el infarto cerebral es el tratamiento de elección en las primeras horas y el retraso es la principal barrera para su empleo. El código ictus (CI) es un sistema que permite una rápida identificación y traslado del paciente con ictus al hospital adecuado para realizarla. Objetivo. Conocer el impacto de extender el CI intrahospitalario (CII) a CI provincial (CIP). Pacientes y métodos. Registro prospectivo de CI atendidos en un centro de ictus provincial. Se recogieron los infartos cerebrales ingresados de forma consecutiva el año previo y posterior al inicio del CIP (1 de noviembre de 2008). Resultados. En un año se atendieron 318 CI: el 61,2% fueron CI extrahospitalarios (CIE). Se trombolizaron 45 pacientes: el 14,2% de las activaciones y el 25,7% de los infartos cerebrales con código activado. La tasa bruta anual de trombólisis fue de 7,7 × 100.000 habitantes (intervalo de confianza del 95%, IC 95% = 5,7-10,4). Medicina primaria activó el 34% de los códigos. No hay diferencias significativas en el porcentaje de activaciones correctas y trombólisis entre CIE y CII. El retraso puerta-aguja es menor en los CIE (59,7 ± 24 frente a 74,4 ± 20 min; p = 0,012). La franja horaria de 22:00 a 08:00 h incluye el 23,6% de los CI y el 22,2% de los trombolizados. Del primer al segundo período, la activación del CI pasa del 11,1 al 37,9% de infartos cerebrales, y la trombólisis aumenta del 3,8 al 12,7% (p < 0,0001; odds ratio = 4,1; IC 95% = 1,9-8,6). Conclusión. El CIP permitió cuadruplicar la trombólisis del infarto cerebral, mejorar la cadena asistencial y extenderla a toda la provincia (AU)


Introduction. Endovenous thrombolysis is the preferred treatment in the early hours following cerebral infarction and delays are the main obstacle preventing it from being used on a more widespread basis. The stroke code (SC) is a system that allows stroke patients to be identified quickly and taken to the most suitable hospital for such treatment to be implemented. Aim. To determine the impact of extending the intra-hospital SC (ISC) to a provincial SC (PSC). Patients and methods. The system consists in a prospective register of cases of SC treated in a provincial stroke centre. Data on the cases of cerebral infarction admitted consecutively the year prior to and after beginning the PSC (1st November 2008) were collected. Results. In one year 318 SC were handled: 61.2% were extra-hospital SC (ESC). A total of 45 patients were thrombolysed: 14.2% of the activations and 25.7% of cerebral infarctions with the code activated. The gross annual rate of thrombolysis was 7.7/100,000 inhabitants (95% confidence interval, 95% CI = 5.7-10.4). Primary medicine activated 34% of the codes. There are no significant differences between ESC and ISC as regards the percentage of correct activations and thrombolysis. The door-to-needle delay is shorter in ESC (59.7 ± 24 versus 74.4 ± 20 minutes; p = 0.012). The time slot from 22 pm to 8 am covers 23.6% of the SC and 22.2% of cases of thrombolysed patients. From the first to the second period, SC activation rises from 11.1% to 37.9% of cerebral infarctions and thrombolysis increases from 3.8 to 12.7% (p < 0.0001; odds ratio = 4.1; 95% CI = 1.9-8.6). Conclusions. The PSC allowed thrombolysis of cerebral infarction to be carried out in four times as many cases, as well as improving the health care chain and extending it throughout the whole province (AU)


Asunto(s)
Humanos , Accidente Cerebrovascular/terapia , Terapia Trombolítica , Atención Prehospitalaria , Transporte de Pacientes/métodos , Accidente Cerebrovascular/epidemiología , Estudios Prospectivos , Códigos Civiles/métodos
2.
Rev Neurol ; 52(8): 457-64, 2011 Apr 16.
Artículo en Español | MEDLINE | ID: mdl-21425098

RESUMEN

INTRODUCTION: Endovenous thrombolysis is the preferred treatment in the early hours following cerebral infarction and delays are the main obstacle preventing it from being used on a more widespread basis. The stroke code (SC) is a system that allows stroke patients to be identified quickly and taken to the most suitable hospital for such treatment to be implemented. AIM. To determine the impact of extending the intra-hospital SC (ISC) to a provincial SC (PSC). PATIENTS AND METHODS: The system consists in a prospective register of cases of SC treated in a provincial stroke centre. Data on the cases of cerebral infarction admitted consecutively the year prior to and after beginning the PSC (1st November 2008) were collected. RESULTS: In one year 318 SC were handled: 61.2% were extra-hospital SC (ESC). A total of 45 patients were thrombolysed: 14.2% of the activations and 25.7% of cerebral infarctions with the code activated. The gross annual rate of thrombolysis was 7.7/100,000 inhabitants (95% confidence interval, 95% CI = 5.7-10.4). Primary medicine activated 34% of the codes. There are no significant differences between ESC and ISC as regards the percentage of correct activations and thrombolysis. The door-to-needle delay is shorter in ESC (59.7 ± 24 versus 74.4 ± 20 minutes; p = 0.012). The time slot from 22 pm to 8 am covers 23.6% of the SC and 22.2% of cases of thrombolysed patients. From the first to the second period, SC activation rises from 11.1% to 37.9% of cerebral infarctions and thrombolysis increases from 3.8 to 12.7% (p < 0.0001; odds ratio = 4.1; 95% CI = 1.9-8.6). CONCLUSIONS: The PSC allowed thrombolysis of cerebral infarction to be carried out in four times as many cases, as well as improving the health care chain and extending it throughout the whole province.


Asunto(s)
Servicios Médicos de Urgencia/organización & administración , Servicios Médicos de Urgencia/normas , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/normas , Accidente Cerebrovascular/terapia , Terapia Trombolítica , Anciano , Isquemia Encefálica/tratamiento farmacológico , Atención a la Salud , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sistema de Registros , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/fisiopatología , Factores de Tiempo , Transporte de Pacientes
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA