María Alonso de Leciñana1,2, Michael V. Mazya3,4, Nikolaos Kostulas3,4, Oscar H. Del Brutto5, Carlos Abanto6, Ayrton R. Massaro7, Mario de Bastos8, Sheila Martins9, Sebastian F. Ameriso10, Fernando Gongora-Rivera11, Claudio Sacks12, Arnold Hoppe13, Patricio Abad14, Gloria Meza15, Antonio Arauz-Gongora16, Nils Wahlgren3,4, Exuperio Díez-Tejedor1,2. 1. Department of Neurology, Stroke Centre, University Hospital La Paz, IdiPAZ, Madrid, Spain (M.A.d.L., E.D.-T.). 2. Universidad Autónoma de Madrid, Spain (M.A.d.L., E.D.-T.). 3. Department of Neurology, Karolinska University Hospital, Sweden (M.V.M., N.K., N.W.). 4. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (M.V.M., N.K., N.W.). 5. School of Medicine, Universidad Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.). 6. Department of Neurovascular Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Perú (C.A.). 7. Department of Neurology, Hospital Sirio-Libanês, Sâo Paulo, Brazil (A.R.M.). 8. Hospital Universitario de Caracas, Venezuela (M.d.B.). 9. Hospital de Clinicas de Porto Alegre and Hospital Moinhos de Vento, Portoalegre, Brazil (S.M.). 10. Institute for Neurological Research FLENI, Buenos Aires, Argentina (S.F.A.). 11. Department of Neurology, Universidad Autónoma de Nuevo Leon, University Hospital José Eleuterio González, Monterrey, México (F.G.-R.). 12. Department of Neurology, Universidad de Valparaíso, Chile (C.S.). 13. Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile (A.H.). 14. Department of Neurology, Hospital Metropolitano, PUCE, Quito, Ecuador (P.A.). 15. Department of Neurology, Instituto de Previsión Social and Hospital Militar Central, Asunción, Paraguay (G.M.). 16. Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico (A.A.-G.).
Abstract
Background and Purpose: Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement. Methods: Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September 2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time, National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality, and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis. Results: Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%) ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%), dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected (median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients. Conclusions: Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.
Background and Purpose: Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of strokepatients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement. Methods: Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September 2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time, National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality, and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis. Results: Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%) ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%), dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected (median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients. Conclusions: Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.
Authors: Verónica V Olavarría; Lorena Hoffmeister; Carolina Vidal; Alejandro M Brunser; Arnold Hoppe; Pablo M Lavados Journal: Front Neurol Date: 2022-04-08 Impact factor: 4.086
Authors: Silvia Reverté-Villarroya; Antoni Dávalos; Sílvia Font-Mayolas; Marta Berenguer-Poblet; Esther Sauras-Colón; Carlos López-Pablo; Estela Sanjuan-Menéndez; Lucía Muñoz-Narbona; Rosa Suñer-Soler Journal: Int J Environ Res Public Health Date: 2020-08-19 Impact factor: 3.390