RESUMO
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.
Assuntos
Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Adulto , Idoso , Encéfalo/diagnóstico por imagem , Isquemia Encefálica/complicações , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/prevenção & controle , Progressão da Doença , Feminino , Hospitais Públicos , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Acidente Vascular Cerebral/complicações , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ativadores de Plasminogênio/uso terapêutico , Terapia Trombolítica/métodos , Isquemia Encefálica/tratamento farmacológico , Acidente Vascular Cerebral/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Fatores de Tempo , Índice de Gravidade de Doença , Infusões Intravenosas , Encéfalo/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/prevenção & controle , Isquemia Encefálica/complicações , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Progressão da Doença , Acidente Vascular Cerebral/complicações , Hospitais PúblicosRESUMO
OBJECTIVE: To know the self-perceived quality of life by elderly patients through two evaluation instruments. METHODS: A prospective, observational, cross-sectional, and descriptive study. Successful information of 178 elder adults attending medical consultation was obtained with the purpose of evaluating the quality of life, through two validated questionnaires: Nottingham Health Profile and Coop/Wonca charts. The U Mann-Whitney and Kruskal-Wallis test were used, with a significant level of 0.05. RESULTS: The worst statistical quality of life variables in both tests were: women, widow, low studies level and no working. In relation with the coexisting chronic medical conditions for the health profile: diabetes mellitus patients showed a worse quality in all dimensions with statistical significance. As for the charts, cardiac disease patients showed the same situation. CONCLUSIONS: In both tests, similar data in relation with the factors that condition a poor quality of life were found.